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胎盘黏连的保守管理-病例报告及文献复习。

Conservative management of morbidly adherant placenta - a case report and review of literature.

机构信息

Maulana Azad Medical College and Lok Nayak Hospital, India.

出版信息

Placenta. 2013 Oct;34(10):963-6. doi: 10.1016/j.placenta.2013.04.016. Epub 2013 Aug 12.

Abstract

Placenta accreta is a condition when the placenta is abnormally adherent to the uterus. This can result in complications like severe haemorrhage, injuries to pelvic organs, possible need for Caesarian hysterectomy. There is always high risk of maternal morbidity and mortality. Over the last decade there has been gradual shift towards conservative management of placenta accreta involving uterine and placental conservation, with the main aim to reduce pelvic injury and to achieve haemostasis with the aid of intervention radiology by means of Uterine Artery embolisation and use of medical chemotherapeutic agents like Methotrexate. This strategy has previously been shown to reduce morbidity and mortality in carefully selected cases of Placenta accreta. We have successfully managed a case of Placenta percreta conservatively using Uterine Artery embolisation followed by Injection methotrexate.

摘要

胎盘植入是指胎盘异常附着于子宫的一种情况。这可能导致严重出血、骨盆器官损伤、可能需要剖腹产子宫切除术等并发症。产妇发病率和死亡率一直很高。在过去的十年中,胎盘植入的保守管理逐渐倾向于保留子宫和胎盘,主要目的是减少骨盆损伤,并借助介入放射学通过子宫动脉栓塞和使用甲氨蝶呤等医学化学治疗药物来实现止血。这一策略已被证明可以在精心挑选的胎盘植入病例中降低发病率和死亡率。我们成功地使用子宫动脉栓塞联合注射甲氨蝶呤对胎盘穿透性胎盘植入进行了保守治疗。

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