Hatfield Joanna L W, Brumsted John R, Cooper Brian C
Department of Obstetrics and Gynecology, University of Vermont College of Medicine, Burlington, Vermont, USA.
J Minim Invasive Gynecol. 2006 Nov-Dec;13(6):510-3. doi: 10.1016/j.jmig.2006.06.013.
Prolonged retained placenta causing a delayed postpartum hemorrhage is a relatively common occurrence. However, there is a dearth of medical literature describing fertility-preserving treatments when standard therapy fails. We present two cases in which protracted retained placenta due to placenta accreta was successfully treated by hysteroscopic resection. Two nulliparous women had spontaneous vaginal deliveries requiring manual placental extraction. Both experienced delayed postpartum hemorrhage and underwent suction curettage with ultrasound guidance. Both patients were found to have persistent products of conception with imaging consistent with placenta accreta. Both patients failed expectant management and subsequently underwent hysteroscopic resection with complete resolution of their symptoms. We conclude that hysteroscopic resection is a conservative therapeutic option for placenta accreta in stable patients.
胎盘长时间滞留导致产后延迟性出血是一种相对常见的情况。然而，当标准治疗失败时，描述保留生育功能治疗方法的医学文献却很匮乏。我们报告两例因胎盘植入导致胎盘长时间滞留而通过宫腔镜切除术成功治疗的病例。两名未生育过的女性经阴道自然分娩，均需人工剥离胎盘。两人都经历了产后延迟性出血，并在超声引导下进行了刮宫术。经影像学检查，两名患者均发现有持续性妊娠产物，与胎盘植入相符。两名患者的期待治疗均失败，随后接受了宫腔镜切除术，症状完全缓解。我们得出结论，对于病情稳定的胎盘植入患者，宫腔镜切除术是一种保守的治疗选择。
