Izabela Ulman-Włodarz, Krzysztof Nowosielski, Ryszard Poreba, Aneta Poreba
Department of Gynecology and Obstetrics, The School of Health Care, Medical University of Silesia, Katowice, Poland.
Ginekol Pol. 2011 Jun;82(6):471-3.
Placenta increta refers to the placenta invading the myometrium. It is a rare but life-threatening condition. The incidence of placenta increta ranges widely from 1 in 540 to 1 in 93,000 deliveries; in Poland it is approximately 0.2% of all deliveries. The occurrence of placenta praevia increta is much lower and accounts for 0.001% to 0.05% of cases. However the frequency of this condition is steadily increasing.
Placenta praevia was diagnosed in an ultrasound examination at 20 weeks' gestation in a multipara who had previously delivered by caesarean section. The invasion of the placental vessels into the caesarean section scar was observed in a Colour Doppler scan. The patient was admitted for a planned caesarean section at 36 weeks' gestation and invasion of the vessels into the caesarean scar was confirmed. Because of uncontrolled hemorrhage, a total abdominal hysterectomy was performed. The patient had an uneventful recovery and was discharged well on the fourth postoperative day with a healthy infant.
Early antenatal detection of placenta praevia increta and planning the surgical intervention tailored to available resources and the patient's expectations result in reducing the number of postpartum maternal, as well as neonatal complications.
胎盘植入是指胎盘侵入子宫肌层。这是一种罕见但危及生命的情况。胎盘植入的发生率差异很大，在每540至93000例分娩中出现1例；在波兰，约占所有分娩的0.2%。前置胎盘合并胎盘植入的发生率更低，占病例的0.001%至0.05%。然而，这种情况的发生率正在稳步上升。
一名经产妇在妊娠20周时超声检查诊断为前置胎盘，该产妇既往有剖宫产史。彩色多普勒扫描观察到胎盘血管侵入剖宫产瘢痕。患者于妊娠36周入院计划剖宫产，血管侵入剖宫产瘢痕得到证实。由于出血无法控制，行全腹子宫切除术。患者恢复顺利，术后第四天康复出院，婴儿健康。
早期产前检测前置胎盘合并胎盘植入，并根据可用资源和患者期望制定手术干预方案，可减少产后母体及新生儿并发症的数量。
