Kaku S, Tsuji S, Ono T, Kimura F, Murakami T
Clin Exp Obstet Gynecol. 2017;44(3):458-460.
A 27-year-old woman with complete placenta previa was referred at 22 weeks of gestation because of vaginal bleeding and fetal growth restriction. At 24 weeks, sudden fetal death occurred, but bleeding continued and transvaginal sonography revealed abundant periplacental blood flow in the uterine wall. To avoid cesarean section, the authors performed uterine artery embolization (UAE) be- fore vaginal delivery of the fetus. Subsequently, there was little bleeding when laminaria was inserted for cervical ripening and the fetus was delivered vaginally by using vaginal gemeprost. Total blood loss was only 149 ml. The present case suggests that UAE may be an option for patients with placenta previa who desire vaginal delivery after intrauterine fetal death (IUFD) in a second-trimester pregnancy.
一名27岁完全性前置胎盘孕妇因阴道出血和胎儿生长受限，于妊娠22周时转诊。孕24周时胎儿突然死亡，但出血仍持续，经阴道超声检查显示子宫壁胎盘周围有丰富血流。为避免剖宫产，作者在经阴道分娩胎儿前进行了子宫动脉栓塞术（UAE）。随后，在插入海藻棒促宫颈成熟时出血很少，使用阴道米索前列醇经阴道分娩出胎儿。总失血量仅149毫升。本病例提示，对于妊娠中期宫内胎儿死亡（IUFD）后希望经阴道分娩的前置胎盘患者，UAE可能是一种选择。
