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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.
- Source :
-
International Journal of Gynecology & Obstetrics . Mar2018, Vol. 140 Issue 3, p312-318. 7p. - Publication Year :
- 2018
-
Abstract
- <bold>Objective: </bold>To identify both the trends in placenta accreta spectrum (PAS) disorders in the context of the universal two-child policy in China and risk factors for hysterectomy.<bold>Methods: </bold>The present retrospective analysis included confirmed PAS disorders during cesarean delivery at a tertiary hospital in Changsha, Hunan, China, from January 1, 2007, to December 31, 2016. Multivariable logistic regression was used to estimate the risk of hysterectomy.<bold>Results: </bold>During the 10-year study period, the overall incidence of cesarean delivery was 51.6% (13 530/26 214) and that of PAS disorders was 1.2% (302/26 214). The PAS rate increased from 0.1% (5/4617) in 2007-2008 to 2.1% (133/6351) in 2015-2016, alongside a rise in elective repeat cesarean delivery from 5.0% (106/2124) to 38.4% (1385/3603). Previous cesarean delivery greatly increased the likelihood of PAS disorders (odds ratio [OR] 97.4; P<0.001). Invasive depth (OR 92.0; P<0.001), inter-cesarean interval less than 36 months (OR 7.0; P=0.002), rural residence (OR 5.3; P=0.018), and advanced maternal age (OR 3.0; P=0.045) were independent risk factors for hysterectomy among women with PAS disorders.<bold>Conclusion: </bold>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. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00207292
- Volume :
- 140
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- International Journal of Gynecology & Obstetrics
- Publication Type :
- Academic Journal
- Accession number :
- 127846859
- Full Text :
- https://doi.org/10.1002/ijgo.12418