La Folie Trévor, Vidal Vincent, Mehanna Mayssoun, Capelle Marianne, Jaquier Alexis, Moulin Guy, Bartoli Jean Michel
Diagnostic Radiology Department, Military Hospital Laveran, Marseille, France.
J Obstet Gynaecol Res. 2007 Oct;33(5):624-30. doi: 10.1111/j.1447-0756.2007.00622.x.
The purpose of this study was to evaluate the clinical success of selective arterial embolization in cases of post-partum hemorrhage due to abnormal placentation.
Six patients with persistent hemorrhage and abnormal placental implantation underwent uterine artery embolization over a period of three years.
In four patients, the placenta was left in place after a gentle attempt at removal and post-partum hemorrhage was controlled during or shortly after the procedure. In all cases, embolization was possible even when there was previous arterial ligation (two cases). In one case, a hysterectomy was required at 21 d later due to uterus and bladder necrosis. Arterial embolization in cases of abnormal placental implantation remains an uncommon treatment and is less efficient in these cases than in normal placental implantation.
Our results confirmed that even in cases of moderate bleeding, conservation treatment and embolization are possible, but that complications may be more common than in normal placentation.
本研究旨在评估选择性动脉栓塞术治疗异常胎盘植入所致产后出血的临床疗效。
在三年期间，对6例持续性出血且胎盘植入异常的患者实施了子宫动脉栓塞术。
4例患者在轻柔尝试取出胎盘后将其留置原位，术中或术后不久产后出血得到控制。在所有病例中，即使先前已进行动脉结扎（2例），仍可行栓塞术。1例患者在21天后因子宫和膀胱坏死而需行子宫切除术。异常胎盘植入病例的动脉栓塞术仍是一种不常见的治疗方法，且在这些病例中的疗效低于正常胎盘植入情况。
我们的结果证实，即使在中度出血的病例中，保留治疗和栓塞术也是可行的，但并发症可能比正常胎盘植入时更常见。
