Abstract:

Abstract： Objective To investigate maternal and fetal outcomes in placenta increta managed by a multidisciplinary care team. Methods A retrospective study was performed in 81 cases of placenta increta between January 2005 and January 2014 in the Third Affiliated Hospital of Guangzhou Medical University．The women were divided into multidisciplinary care team group in whole process，multidisciplinary care team group in the stage of delivery and standard obstetric care team group. The maternal and fetal outcomes in placenta accreta was evaluated.Results The blood loss［（1453.2±991.2）mL and (1536.4±1001.3）］mL，packed red blood cells (pRBCs) transfusion［（592.1±301.2 ）mL and (632.4±279.8）mL］ and early composite morbidity［26.5%（9/34） and 31.8%（7/22）］ in multidisciplinary care team group in whole process and multidisciplinary care team group in the stage of delivery were lower than standard obstetric care team group［(1889.3±1403.4) mL、(721.4±298.1) mL and 60.0%（15/25）］（P＜0.05）. Conclusion multidisciplinary care team management can improve maternal outcomes of placenta increta, but not neonatal ones.

Key words: placenta increta, postpartum hemorrhage, multidisciplinary care team, maternal and fetal outcomes

摘要：

目的 探讨多学科团队参与对胎盘植入患者母婴结局的影响。方法 选择2005年1月1日至2014年1月1日在广州医科大学附属第三医院分娩的临床资料完整的81例胎盘植入患者。根据多学科团队（多团队）参与的情况，分为全程（妊娠期及分娩期）多团队参与组，分娩期多团队参与组，和分娩期无多团队参与（仅有产科与新生儿科）组。回顾性分析三组胎盘植入患者的母儿结局。 结果 在植入性胎盘中全程多团队参与组和分娩期多团队参与组出血量[（1453.2±991.2）mL和(1536.4±1001.3）mL]、术中输血量[（592.1±301.2）mL和(632.4±279.8）mL]以及早期并发症的比例[26.5%（9/34）和31.8%（7/22）]均低于分娩期无多团队参与组[(1889.3±1403.4)mL、(721.4±298.1)mL和60.0%（15/25）]（P<0.05）。结论 多学科团队参与治疗植入性胎盘可改善产妇妊娠结局，但对新生儿结局则无影响。

关键词: 胎盘植入, 产后出血, 多团队参与, 母儿结局