Placenta accreta spectrum disorder trends in the context of the universal two‐child policy in China and the risk of hysterectomy

Zeng, Chanjuan; Yang, Mengyuan; Ding, Yiling; Duan, Siqi; Zhou, Yang

doi:10.1002/ijgo.12418

Cited by 40 publications

(36 citation statements)

References 24 publications

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“…Invasion depth has been previously illustrated to be one of the risk factors for hemorrhage and hysterectomy in patients with placenta accrete [15]. In accordance with this result, our subsequent analysis disclosed that accrete depth was an independent risk factor for EBL in pernicious placenta previa patients with placenta accrete.…”

Section: Discussionsupporting

confidence: 85%

Comparison of Efficacy between Internal Iliac Artery and Abdominal Aorta Balloon Occlusions in Pernicious Placenta Previa Patients with Placenta Accrete

Yan

Luo

2019

Gynecol Obstet Invest

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Background: We aimed to compare the hemostatic effect and perioperative outcomes between internal iliac artery (IIA) and abdominal aorta (AA) balloon occlusions in pernicious placenta previa patients complicated with placenta accrete and underwent cesarean delivery. Methods: One hundred and twenty-three pernicious placenta previa patients complicated with placenta accrete were retrospectively reviewed. Patients who received IIA or AA occlusions were subsequently divided into the IIA group (n = 71) and AA group (n = 52). Estimated blood loss (EBL) and blood transferring volume were evaluated. Results: No difference was observed in EBL during cesarean delivery, EBL within 24 h or blood transferring volume between IIA and AA groups. Subgroup analysis disclosed that AA occlusion presented lower EBL during cesarean delivery and EBL within 24 h compared to IIA occlusion in placenta percreta subgroup. For secondary outcomes, IIA occlusion caused better Apgar score at 1 min but higher rates of IIA ligation and iodoform gauze packing of the uterine cavity compared to AA occlusion. Multivariate linear analysis revealed that invasion depth independently predicted worse EBL. Conclusion: IIA and AA occlusions have similar hemostatic effects in pernicious placenta previa patients with placenta accrete underwent cesarean delivery, while AA occlusion is more effective in reducing EBL in placenta percreta subgroup.

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Section: Discussionsupporting

confidence: 85%

Comparison of Efficacy between Internal Iliac Artery and Abdominal Aorta Balloon Occlusions in Pernicious Placenta Previa Patients with Placenta Accrete

Yan

Luo

2019

Gynecol Obstet Invest

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“…Some questions remain about the impacts of the birth policy changes on maternal and infant health. To date, the impact of birth policy changes on women's reproductive decisions, delivery mode, pregnancy complications, pregnancy age, and birth outcomes has been reported [6][7][8][9][10][11]. An association between certain maternal characteristics and birth defects (BDs) has also been reported, such as maternal age, maternal parity, use of assisted reproductive technology, and diabetes mellitus [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Changes in maternal age and prevalence of congenital anomalies during the enactment of China's universal two-child policy (2013–2017) in Zhejiang Province, China: An observational study

et al. 2020

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Background China implemented a partial two-child policy (2013) followed by a universal two-child policy (2015), replacing the former one-child policy mandated by the government. The changes affect many aspects of China's population as well as maternal and infant health, but their potential impact on birth defects (BDs) remains unknown. In this study, we investigated the associations of these policy changes with BDs in Zhejiang Province, China. Methods and findings We used data from the BD surveillance system in Zhejiang Province, China, which covers 90 hospitals in 30 urban districts and rural counties, capturing one-third of the total births in this province. To fully consider the time interval between conception and delivery, we defined the one-child policy period as data from 2013 (births from October 2012 to September 2013), the partial two-child policy period as data from 2015 (births from October 2014 to September 2015), and the universal two-child policy period as data from 2017 (births from October 2016 to September 2017). Data from 2009 and 2011 were also used to show the changes in the proportion of births to women with advanced maternal age (35 years and older) prior to the policy changes. Main outcome measures were changes in the proportion of mothers with advanced maternal age, prevalence of BDs, rankings of BD subtypes by prevalence, prenatal diagnosis rate, and live birth rate of BDs over time. A total of 1,260,684 births (including live births, early fetal losses, stillbirths, and early neonatal deaths) were included in the analyses. Of these, 644,973 (51.16%) births were to women from urban

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“…Carusi (20) and Zeng et al (35) both considered age to be a risk factor for PA. However, after stratification in multivariate FIGURE 1 | Placenta accreta Risk Assessment Tool.…”

Section: Discussionmentioning

confidence: 99%

Development of a Novel Nomogram for Predicting Placenta Accreta in Patients With Scarred Uterus: A Retrospective Cohort Study

Yang

Qiao

et al. 2019

Front. Med.

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The aim of this study was to develop a nomogram to predict the risk of placenta accreta in scarred uterus patients in China. Methods: We retrospectively analyzed 8,371 singleton pregnancies with scarred uterus at Shengjing Hospital, affiliated with China Medical University. Two thirds of the patients were randomly assigned to the training set (n = 5,581), and one third were assigned to the validation set (n = 2,790). Multivariate logistic regression was performed by using the training set, and the nomogram was developed. Discrimination and calibration were performed by using both the training and validation sets. Results: The multivariate logistic regression model identified number of previous cesarean section, number of vaginal bleeding, medication during pregnancy, and placenta previa as covariates associated with placenta accreta. A nomogram was developed to predict the risk of placenta accreta in the training set with a Harrell's C-index of 0.93 and 0.927 in the training set and validation set, respectively. Calibration of the nomogram predicted placenta accreta corresponding closely with the actual placenta accreta. Conclusion: We developed a nomogram predicting the risk of placenta accreta in scarred uterus patients in China. Validation using both the training set and the validation set demonstrated good discrimination and calibration, suggesting good clinical utility.

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Placenta accreta spectrum disorder trends in the context of the universal two‐child policy in China and the risk of hysterectomy

Abstract: The increasing incidence of elective repeat cesarean delivery combined with a high overall rate of cesarean delivery implies a high prevalence of PAS disorders within the context of the universal two-child policy in China. The main predictor of hysterectomy was invasive depth.

Cited by 40 publications

References 24 publications

Comparison of Efficacy between Internal Iliac Artery and Abdominal Aorta Balloon Occlusions in Pernicious Placenta Previa Patients with Placenta Accrete

Comparison of Efficacy between Internal Iliac Artery and Abdominal Aorta Balloon Occlusions in Pernicious Placenta Previa Patients with Placenta Accrete

Changes in maternal age and prevalence of congenital anomalies during the enactment of China's universal two-child policy (2013–2017) in Zhejiang Province, China: An observational study

Development of a Novel Nomogram for Predicting Placenta Accreta in Patients With Scarred Uterus: A Retrospective Cohort Study

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