Hiraki Koichi, Khan Khaleque Newaz, Kitajima Michio, Fujishita Akira, Masuzaki Hideaki
Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
J Obstet Gynaecol Res. 2014 Jan;40(1):89-95. doi: 10.1111/jog.12128. Epub 2013 Aug 12.
To examine clinical and surgical performances of cases with placental polyps in which uterine preservation surgery was conducted.
During the period September 2002 to April 2009, we examined eight cases (hysteroscopic resection, six cases; laparotomy, one case; dilatation and curettage, one case) diagnosed with placental polyp that had been treated with polyp extraction surgery. Imaging evaluation was done using magnetic resonance imaging and 2-D ultrasound.
Three of the eight cases (37.5%) had been first-time pregnancies. Most of our cases experienced minimal surgical manipulation after medical abortion. Among them, six cases (75%) were mid-term medical abortions, one case (12.5%) received no treatment after spontaneous abortion, and one case (12.5%) had postsurgical abortion (dilatation and curettage). All cases showed variable amount of blood flow in the internal mass and myometrium by color Doppler ultrasound. Magnetic resonance imaging angiography showed contrast effects in the intrauterine cavity and myometrium in selected cases. The average duration from diagnosis to surgery was 32 days (range, 11-105). Color Doppler revealed a reduction in blood flow in five cases during the waiting period until surgery with an average blood loss of 10 g (range, 0-20) during surgery.
Use of color Doppler ultrasound may be useful in diagnosing placental polyp. Although hysteroscopic resection of placental polyp is effective in patients hoping for uterine preservation, delaying timing of surgery may reduce blood loss during operative procedure.
研究行子宫保留手术的胎盘息肉病例的临床及手术表现。
2002年9月至2009年4月期间，我们检查了8例经息肉摘除手术治疗的诊断为胎盘息肉的病例（宫腔镜切除术6例；剖腹手术1例；刮宫术1例）。使用磁共振成像和二维超声进行影像学评估。
8例中有3例（37.5%）为首次妊娠。我们的大多数病例在药物流产后手术操作极少。其中，6例（75%）为中期药物流产，1例（12.5%）自然流产后未接受治疗，1例（12.5%）术后流产（刮宫术）。所有病例经彩色多普勒超声检查显示内部肿物及子宫肌层血流情况各异。磁共振成像血管造影在部分病例中显示宫腔及子宫肌层有造影剂增强效应。从诊断到手术的平均时间为32天（范围11 - 105天）。彩色多普勒显示5例在等待手术期间血流减少，手术期间平均失血量为10克（范围0 - 20克）。
彩色多普勒超声可能有助于诊断胎盘息肉。尽管宫腔镜切除胎盘息肉对希望保留子宫的患者有效，但延迟手术时机可能减少手术过程中的失血量。
