ABSTRACT
@#：【Objective】Toprovidefurtherevidenceoftheassociationbetweencesareanscarpregnancy（CSP）and placentaincreta，andtoinvestigatetheriskofexpectantmanagementofCSP.【Methods】Aretrospectivereviewof3women diagnosedwithCSP，whoweremanagedexpectantly，wasperformedintheThirdAffiliatedHospitalofSUNYat-sen UniversityfromJanuary2014toDecember2018.Theirclinicalcharacteristics，sonographicmanifestationandpoorout⁃ comeswereanalyzed.【Results】These3casesofCSPhad1~2previouslowersegmentcesareansectionsandtheirclinical symptomsincludedrecurrenthemorrhage，grosshematuriaandsevereabdominalpain.Amongthe3cases，thegestational ageatdiagnosisofCSPwas6+2weeks，7weeksand7+4weeks，respectively；thesonographicCSPtypewastypeⅠ，type ⅡandtypeⅢ，respectively；thegestationalageatthefirstdiagnosisofplacentaincretawas24+4weeks，12+2weeksand 13+1weeks，respectively；andall3caseswerediagnosedasplacentapercretabyultrasoundatthesecondtrimester.These 3casesofCSPwereterminatedatthesecondtrimesterwithoutlivebornneonatesbecauseofseverehemorrhage，colt tamponadeofbladderanduterinerupture；andallwereconfirmedasplacentapercretaduringsurgerywiththetotalblood lossofmorethan2500mLandwithoutmaternaldeath，andonegotapathologicaldiagnosisofplacentapercretaafter subtotal hysterectomy.【Conclusion】Placenta percreta should be noticed during the expectant management of CSP becauseof the close association between CSP and placenta increta. Natural history of CSP is usually associated with adverseoutcome，andthereforeexpectantmanagementofCSPshouldbecarefullychosen
ABSTRACT
[Objective]To investigate awareness of hepatitis B virus(HBV)infection and its mother to child transmis-sion(MTCT)among pregnant women attending their first prenatal visit.[Methods]Pregnant women who attended their first prenatal visit to obstetrics outpatient department of the third affiliated hospital of SUN Yat-sen University from May to Aug. 2014,were invited to participate this survey.The self-administered questionnaire about mother to child transmission of HBV was completed anonymously.Data were collected and using ANOVA and logistic analysis to assess the awareness of hepatitis B and its MTCT,and attitudes towards prevention of MTCT of HBV,and to analyze the effective factors of knowledge and at-titudes.[Results]①Of the 500 questionnaires,the effective response rate was 91.8%(459/500).② The total knowledge score of 11 knowledge questions was 11,and the mean score of participants was 6.09 ± 3.29(M±SD). Only about 50% of participants were aware of the complications of hepatitis B and increasing these complications if caused by MTCT. 65.3% of participants knew hepatitis B vaccine.The awareness about modes of HBV transmission including through blood,unprotected sexual intercourse,MTCT and unsafe needles or sharps were 72.0%,48.9%,75.9% and 66.3%,respectively.③The total attitudes score of 6 attitudes questions was 6,and the mean score of participants was 3.84±1.50(M±SD).More than 80% of pregnant women were willing to be screened for hepatitis B,and let neonate receive HBV vaccine.If diagnosed with hepatitis B,83.1% of pregnant women were willing to let neonate receive hepatitis B immunoglobulin,however,only 16.2% would take drugs to prevent MTCT of HBV.④Education with college or higher level was the independent effective factors associat-ed with better knowledge scores(OR=5.96,95%CI:2.95~12.06).Higher education level was the independent effective fac-tor associated with better attitude scores;when compared with junior high or below,the OR values of senior high and college or higher were 1.90(95%CI:1.01~3.55)and 2.50(95%CI:1.43~4.33),respectively.[Conclusion]Although education level is an independent effective factor associated with knowledge of hepatitis B and attitude towards prevention of MTCT of HBV,lack of knowledge about hepatitis B is common among first prenatal-visiting pregnant women,and more education about hepatitis B is necessary.