Department of Obstetrics and Gynecology, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo, Japan. endot @ sapmed.ac.jp
Gynecol Obstet Invest. 2010;69(2):112-5. doi: 10.1159/000262320. Epub 2009 Nov 28.
Treatment of placenta increta often entails abdominal total hysterectomy. We present a case of placenta increta in which 3-dimensional computed tomography shows very high blood flow to the placenta, even after chemotherapy with methotrexate. Nonetheless, we were able to remove the region of the uterus that had been invaded by chorionic villi. Massive bleeding during the operation was prevented by ligation of the hypogastric artery and local injection of vasopressin. The combination of chemotherapy and partial resection of the uterus is quite a unique treatment for placenta increta patients. This approach enabled preservation of the uterus and the patient's fertility. We suggest this procedure could be one of the treatments for patients who have placenta increta and wish to retain their fertility.
胎盘植入的治疗方法常需进行剖腹子宫全切除术。我们报告一例胎盘植入患者，即使在甲氨蝶呤化疗后，三维 CT 仍显示胎盘血供非常丰富。尽管如此，我们仍能够切除被绒毛膜侵入的子宫区域。通过结扎下腹动脉和局部注射血管加压素，防止了手术中大量出血。化疗和子宫部分切除术的联合治疗对胎盘植入患者来说是一种非常独特的治疗方法。这种方法能够保留子宫和患者的生育能力。我们建议，对于希望保留生育能力的胎盘植入患者，该手术可以作为一种治疗方法。
