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完全性前置胎盘原位保留——延迟子宫切除术治疗：病例报告

Placenta previa percreta left in situ - management by delayed hysterectomy: a case report.

作者信息

Tikkanen Minna, Stefanovic Vedran, Paavonen Jorma

机构信息

Helsinki University Hospital, Department of Obstetrics and Gynecology, Helsinki, Finland.

出版信息

J Med Case Rep. 2011 Aug 25;5:418. doi: 10.1186/1752-1947-5-418.

DOI:10.1186/1752-1947-5-418
PMID:21867547
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3177929/
Abstract

INTRODUCTION

Placenta percreta is an obstetric emergency often associated with massive hemorrhage and emergency hysterectomy.

CASE PRESENTATION

We present the case of a 30-year-old African woman, gravida 7, para 5, with placenta percreta managed by an alternative approach: the placenta was left in situ, methotrexate was administered, and a delayed hysterectomy was successfully performed.

CONCLUSIONS

Further studies are needed to develop the most appropriate management option for the most severe cases of abnormal placentation. Delayed hysterectomy may be a reasonable strategy in the most severe cases.

摘要

引言

穿透性胎盘植入是一种产科急症，常伴有大量出血及急诊子宫切除术。

病例报告

我们报告一例30岁非洲女性病例，孕7产5，采用替代方法处理穿透性胎盘植入：胎盘原位保留，给予甲氨蝶呤，并成功实施了延迟子宫切除术。

结论

需要进一步研究以制定针对最严重胎盘植入异常病例的最恰当管理方案。在最严重的病例中，延迟子宫切除术可能是一种合理的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a31/3177929/2762974edc18/1752-1947-5-418-6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a31/3177929/4cde17e68de8/1752-1947-5-418-1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a31/3177929/2762974edc18/1752-1947-5-418-6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a31/3177929/4cde17e68de8/1752-1947-5-418-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a31/3177929/2b95419f0568/1752-1947-5-418-2.jpg
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本文引用的文献

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Antenatal diagnosis of placenta accreta leads to reduced blood loss.产前诊断胎盘植入可减少出血量。
Acta Obstet Gynecol Scand. 2011 Oct;90(10):1140-6. doi: 10.1111/j.1600-0412.2011.01147.x. Epub 2011 May 25.
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Placenta accreta.胎盘植入
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Effect of predelivery diagnosis in 99 consecutive cases of placenta accreta.99 例胎盘植入症的产前诊断效果。
Obstet Gynecol. 2010 Jan;115(1):65-69. doi: 10.1097/AOG.0b013e3181c4f12a.
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Surgical management of placenta accreta: a cohort series and suggested approach.胎盘植入的外科处理：队列系列研究和建议方法。
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Diagnosis and management of placenta accreta.胎盘植入的诊断与管理
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Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta.超声检查和磁共振成像在胎盘植入诊断中的准确性。
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