Ferrazzani Sergio, Guariglia Lorenzo, Triunfo Stefania, Caforio Leonardo, Caruso Alessandro
Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
Fetal Diagn Ther. 2009;25(4):400-3. doi: 10.1159/000236154. Epub 2009 Sep 30.
Placenta previa-accreta is associated with severe hemorrhage occurring while separating the placenta during cesarean delivery and hysterectomy is considered the treatment of choice. Conservative management has recently been proposed.
A 26-year-old woman had pregnancy complicated by placenta previa with suspected accreta. During elective cesarean section a prophylactic double bilateral ligation of uterine arteries was performed before removal of the placenta; subsequently, the continuous small bleeding from the placental bed was stopped by tamponade with a balloon catheter filled with saline solution. The patient was discharged 5 days later. An ultrasonographic color Doppler follow-up demonstrated a renewed uterine vascularization.
Double bilateral ligation of uterine arteries can be used as a prophylactic surgical treatment when a severe bleeding because of placenta previa-accreta is expected, in order to avoid hysterectomy.
前置胎盘伴植入与剖宫产术中胎盘剥离时发生严重出血相关，子宫切除术被认为是首选治疗方法。最近有人提出保守治疗。
一名26岁女性妊娠合并前置胎盘，怀疑有胎盘植入。在择期剖宫产时，于胎盘娩出前预防性双侧子宫动脉双重结扎；随后，用充满生理盐水的球囊导管压迫止血，胎盘床持续少量出血得以停止。患者5天后出院。超声彩色多普勒随访显示子宫血管再生。
当预计因前置胎盘伴植入导致严重出血时，双侧子宫动脉双重结扎可作为一种预防性外科治疗方法，以避免子宫切除术。
