Greenberg James A, Miner Julie D, O'Horo Susan K
Department of Obstetrics and Gynecology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
J Minim Invasive Gynecol. 2006 Jul-Aug;13(4):342-4. doi: 10.1016/j.jmig.2006.04.008.
Retained placenta is a serious cause of postpartum hemorrhage. Compounding this problem is the rare finding of a retained placenta accreta. Different authors have presented management options for retained placenta accreta that include methotrexate, uterine artery embolization, dilation and curettage, hysteroscopic loop resection, and hysterectomy. We report here on a patient who was diagnosed with a retained placenta accreta and underwent successful conservative treatment with uterine artery embolization followed by hysteroscopic morcellation. Whereas other methods have failed due to bleeding and/or infection, this case illustrates a potential new means of addressing this challenging obstetrical complication.
胎盘滞留是产后出血的一个严重原因。更复杂的是,胎盘植入这种罕见情况也时有发生。不同作者提出了胎盘植入的处理方法,包括甲氨蝶呤、子宫动脉栓塞、刮宫术、宫腔镜下环形切除术和子宫切除术。我们在此报告一例被诊断为胎盘植入的患者,该患者成功接受了子宫动脉栓塞术,随后进行了宫腔镜下碎切术的保守治疗。鉴于其他方法因出血和/或感染而失败,该病例说明了一种应对这种具有挑战性的产科并发症的潜在新方法。