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接受剖腹产的妇女的泌尿系统并发症因为胎盘缩谱系障碍:系统性审查和元分析
A Lucidi1, E Jauniaux2, A M Hussein3
1Center for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy.
概括
由于胎盘增生谱系障碍 (PAS) 而接受剖腹产的妇女面临尿道并发症的重大风险,主要是囊切除术. 在胎盘形和紧急手术的情况下,这种风险增加,这凸显了对标准化诊断方案的需求.
科学领域:
- 泌尿和妇科 泌尿和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 手术瘤学手术瘤学
背景情况:
- 胎盘积分谱 (PAS) 障碍在剖腹产期间带来了重大的外科挑战.
- 泌尿系统并发症是与复杂的产科手术相关的已知风险,例如PAS的剖腹产.
研究的目的:
- 系统地审查和分析在接受PAS剖腹产的妇女中泌尿系统并发症的发生率.
- 确定与PAS手术相关的特定风险因素和泌尿病发病率类型.
主要方法:
- 在MEDLINE,EMBASE和Cochrane数据库中进行了全面的电子搜索,直到2022年11月.
- 数据提取和偏差风险评估由两位独立审稿人进行.
- 随机效应的比例元分析被用来合成有关泌尿病并发症率的数据.
主要成果:
- 泌尿器科并发症发生在15.2%的病例中,囊切除是最常见的 (13.5%).
- 在胎盘穿 (38.5%) 和紧急干预 (24.6%) 的情况下,观察到更高的并发症率.
- 亚组分析显示,根据手术方法和PAS严重程度,发生率各不相同.
结论:
- 接受PAS手术的女性具有高风险的泌尿症并发症,主要是囊切除.
- 胎盘形和紧急手术与泌尿病发病率的增加有关.
- 需要标准化诊断协议来识别产前成像预测尿道风险的迹象.
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