胎盘增长频谱:指导方针的全面审查
Sonia Giouleka1, Ioannis Tsakiridis2, Evangelia-Rafaela Chanioti1
1Resident.
Obstetrical & gynecological survey
|June 19, 2024
概括
胎盘积分谱 (PAS) 准则显示出对诊断和多学科管理的共识. 然而,最佳的分娩时间和麻醉仍然存在争议,需要标准化的国际协议以获得更好的结果.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 胎盘积分谱 (PAS) 障碍涉及异常的胎盘侵袭,造成母亲发病率和死亡率的重大风险.
- PAS的发病率正在上升,主要是由于阳性原因,突显了需要有效的管理策略的需要.
研究的目的:
- 审查和比较最近的国际指导方针关于诊断和管理的胎盘积分谱 (PAS) 障碍.
- 确定有关PAS的主要产科指南中共识和分歧的领域.
主要方法:
- 对国际知名产科组织的指导方针进行了描述性审查.
- 分析了ACOG,RANZCOG,IS-PAS,RCOG,FIGO和SOGC的指南,以提供诊断和管理建议.
主要成果:
- 在PAS定义和使用超声波诊断方面存在共识,MRI保留用于胎盘延伸.
- 所有指导方针都强调多学科的团队方法和第三级中心的交付.
- 切除子宫,预期和保守的管理是可以接受的;不建议进行常规的尿路支架和盆腔动脉封闭. 不建议使用甲托雷克萨特.
结论:
- 针对PAS查,诊断和管理的标准化国际协议对于改善妊娠结果至关重要.
- 需要进一步研究和就最佳分娩时间,麻醉和PAS手术方法达成共识.
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