St. Marianna University School of Medicine, Obstetrics and Gynecology, Kawasaki, Japan.
Fertil Steril. 2011 Jan;95(1):290.e9-11. doi: 10.1016/j.fertnstert.2010.04.081. Epub 2010 Jun 20.
To report a case of full-term delivery after uterine artery embolization with N-butyl cyanoacrylate for abruptio placentae.
Case report.
University hospital.
PATIENT(S): A 35-year old woman, gravida 2 para 0, at 32 weeks' and 4 days' gestation.
INTERVENTION(S): Transcatheter arterial embolization with N-butyl cyanoacrylate (NBCA).
RESULT(S): An emergency cesarean section was performed for abruptio placentae. The neonate died on day 0. After the cesarean section, a hematoma was found at the uterine incision that continued to increase. Therefore, pelvic angiography was performed, and extravasation was observed from the uterine arteries. NBCA was used for embolization, and the extravasation stopped rapidly. Total transfusion volume was 10,190 mL. Nine months after the cesarean section, the patient became pregnant naturally and delivered a boy by elective cesarean section.
CONCLUSION(S): For treatment of shock caused by perinatal hemorrhage, which is a major cause of perinatal mortality, even if clotting abnormalities are present, transcatheter arterial embolization using NBCA can provide effective hemostasis. Moreover, in patients who would otherwise require a hysterectomy, fertility can be preserved.
报告一例胎盘早剥患者经 N-丁基氰基丙烯酸酯子宫动脉栓塞后足月分娩的病例。
病例报告。
大学医院。
35 岁女性，孕 2 产 0，妊娠 32 周 4 天。
经导管动脉栓塞用 N-丁基氰基丙烯酸酯（NBCA）。
因胎盘早剥行紧急剖宫产术，新生儿于第 0 天死亡。剖宫产术后发现子宫切口处血肿并持续增大，行骨盆血管造影，观察到子宫动脉外渗，用 NBCA 栓塞，外渗迅速停止。总输血量为 10190ml。剖宫产术后 9 个月，患者自然受孕并择期行剖宫产娩出一男婴。
对于围生期出血引起的休克的治疗，即使存在凝血异常，使用 NBCA 的经导管动脉栓塞也能提供有效的止血效果。此外，对于那些需要子宫切除术的患者，可以保留生育能力。
