胎盘植入相关自发性子宫穿孔的保守治疗：一例报告
Conservative management of spontaneous uterine perforation associated with placenta accreta: a case report.
作者信息
Gherman Robert B, Lockrow Ernest G, Flemming Donald J, Satin Andrew J
机构信息
Division of Maternal/Fetal Medicine, Department of Obstetrics and Gynecology, National Naval Medical Center, Bethesda, Maryland 20889, USA.
出版信息
J Reprod Med. 2004 Mar;49(3):210-3.
BACKGROUND
Placenta accreta occurring in an unscarred uterus is exceedingly rare. Previous cases of spontaneous uterine perforation associated with placenta accreta were treated with hysterectomy.
CASE
A nulliparous woman was clinically diagnosed with placenta accreta when spontaneous vaginal delivery was complicated by postpartum hemorrhage and a retained placenta. Magnetic resonance imaging subsequently revealed focal areas of placenta accreta. Acute-onset abdominal pain and cul-de-sac fluid prompted diagnostic laparoscopy, which revealed a spontaneous uterine perforation in the right posterior-lateral aspect of the uterus. This area was oversewn, and the patient received 2 weeks of postoperative antibiotics because of Enterococcus faecalis bacteremia.
CONCLUSION
Spontaneous uterine perforation associated with placenta accreta can be managed conservatively.
背景
胎盘植入发生于未受过损伤的子宫极为罕见。既往与胎盘植入相关的自发性子宫穿孔病例均行子宫切除术治疗。
病例
一名未生育过的女性在顺产并发产后出血及胎盘残留时临床诊断为胎盘植入。随后磁共振成像显示胎盘植入的局灶区域。急性腹痛及盆腔积液促使进行诊断性腹腔镜检查，结果显示子宫右后外侧出现自发性子宫穿孔。对该区域进行了缝合，由于粪肠球菌菌血症，患者术后接受了2周的抗生素治疗。
结论
与胎盘植入相关的自发性子宫穿孔可采用保守治疗。
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