胎盘植入保守治疗后阿谢曼综合征的检测：一例报告
Detection of Asherman's syndrome after conservative management of placenta accreta: a case report.
作者信息
Chikazawa Kenro, Imai Ken, Liangcheng Wang, Sasaki Shigetane, Horiuchi Isao, Kuwata Tomoyuki, Takagi Kenjiro
机构信息
Perinatal Center, Division of Maternal Fetal Medicine, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan.
出版信息
J Med Case Rep. 2018 Nov 20;12(1):344. doi: 10.1186/s13256-018-1869-7.
BACKGROUND
We present a case involving conservative treatment of placenta accreta, with a subsequent diagnosis of Asherman's syndrome.
CASE PRESENTATION
A 41-year-old Japanese woman (G2P0A2) delivered a healthy male infant via cesarean section due to preeclampsia. The placenta did not spontaneously separate and was manually removed. Adhesion was tight and placenta accreta was diagnosed. During the procedure, no uterine inversion or perforation, and no uterine cavity adhesion, were observed. Four months postoperatively, hysteroscopy was performed. Adhesion was detected at the fundus of her uterus where the placenta had adhered to the uterus. Asherman's syndrome was diagnosed.
CONCLUSIONS
Asherman's syndrome might occur after conservative management of placenta accreta, which may be a direct cause of placenta accreta recurrence. When Asherman's syndrome is diagnosed, the site of the placenta and adhesion should be monitored during subsequent pregnancies.
背景
我们报告一例胎盘植入保守治疗后并发宫腔粘连综合征（Asherman综合征）的病例。
病例报告
一名41岁的日本女性（孕2产0，流产2次）因子痫前期行剖宫产术，娩出一名健康男婴。胎盘未自行剥离，行人工剥离。发现粘连紧密，诊断为胎盘植入。术中未发现子宫内翻或穿孔，也未发现宫腔粘连。术后4个月，患者接受宫腔镜检查，发现胎盘附着部位的子宫底部存在粘连，诊断为宫腔粘连综合征。
结论
胎盘植入保守治疗后可能发生宫腔粘连综合征，这可能是胎盘植入复发的直接原因。诊断为宫腔粘连综合征后，后续妊娠期间应监测胎盘附着部位及粘连情况。
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