一名患有胎盘植入的患者计划进行中期妊娠引产子宫切除术。
Scheduled hysterectomy for second-trimester abortion in a patient with placenta accreta.
作者信息
Tocce Kristina, Thomas Virginia Worth, Teal Stephanie
机构信息
From the University of Colorado Denver School of Medicine, Aurora, Colorado.
出版信息
Obstet Gynecol. 2009 Feb;113(2 Pt 2):568-570. doi: 10.1097/AOG.0b013e318194258c.
BACKGROUND
As cesarean deliveries increase, so does placenta accreta. There is little evidence regarding management of patients with known or suspected abnormal placentation seeking abortion.
CASE
A medically complicated patient with evidence of placenta increta on magnetic resonance imaging presented for pregnancy termination at 15 weeks of gestation. Scheduled hysterectomy was performed to avoid hemorrhage and subsequent complications. The patient did well postoperatively; her course was complicated only by a wound infection treated as an outpatient. Pathology was consistent with placenta increta.
CONCLUSION
Placenta accreta has increased 13-fold in the past 30 years. In select patients with evidence of abnormal placentation, scheduled hysterectomy for termination of pregnancy is an option that may be considered.
背景
随着剖宫产率的上升，胎盘植入的发生率也在增加。对于已知或疑似胎盘植入异常且寻求流产的患者，相关治疗证据很少。
病例
一名患有多种内科疾病的患者，磁共振成像显示有胎盘植入增加的迹象，在妊娠15周时前来终止妊娠。为避免出血及后续并发症，实施了计划性子宫切除术。患者术后恢复良好；其病程仅因门诊治疗的伤口感染而复杂化。病理结果与胎盘植入增加相符。
结论
在过去30年中，胎盘植入增加了13倍。对于部分有胎盘植入异常证据的患者，计划性子宫切除术作为终止妊娠的一种选择可以考虑。
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