r0c[医药]RCOG 前置胎盘并植入的诊断与处理.pdfVIP

Guideline No. 27 Revised October 2005 PLACENTA PRAEVIA AND PLACENTA PRAEVIA ACCRETA: DIAGNOSIS AND MANAGEMENT This is the second edition of this guideline.The original edition, entitled Placenta Praevia: Diagnosis and Management, was published in January 2001. 1. Aim and introduction Maternal and fetal morbidity and mortality from placenta praevia are considerable1–9 and are associated with high demands on health resources.With the rising incidence of caesarean section operations combined with increasing maternal age, the numbers of cases of placenta praevia and its complications will continue to increase,7,8,10–14 so updating the guideline for this condition is timely.The purpose of this guideline is to address the methods of diagnosing placenta praevia and placenta praevia accreta and their clinical management in both the antenatal and peripartum periods. Placenta praevia exists when the placenta is inserted wholly or in part into the lower segment of the uterus. If it lies over the cervical os, it is considered a major praevia, if not, then minor praevia exists.This diagnosis has evolved from the original clinical I–IV grading system and is determined by ultrasonic imaging techniques relating the leading edge of the placenta to the cervical os. Management decisions for women with placenta praevia are based on clinical and ultrasound findings. 2. Identification and assessment of evidence To update this guideline, the Cochrane Library 2004, Issue 2, and Embase and Medline were searched for relevant randomised controlled trials (RCT),systematic reviews and meta-analyses relating to placenta praevia from 2000 to 2004 (the search for the previous guidelines was up to April 2000)