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一位有六次剖宫产史患者的胎盘植入谱系疾病:逐步管理

Placenta Accreta Spectrum Disorder in a Patient with Six Previous Caesarean Deliveries: Step by Step Management.

作者信息

Gloria Calagna, Salvatore Polito, Francesco Labate, Anna Guiglia Rosa, Francesca De Maria, Chiara Bisso, Gaspare Cucinella, Giuseppe Calì

机构信息

Obstetrics and Gynecology, "Villa Sofia-Cervello" Hospital, Palermo, Italy.

University of Palermo, Palermo, Italy.

出版信息

Case Rep Obstet Gynecol. 2021 Sep 12;2021:2105248. doi: 10.1155/2021/2105248. eCollection 2021.

DOI:10.1155/2021/2105248
PMID:34552802
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8452425/
Abstract

The definition (PAS) introduced by FIGO (International Federation of Gynaecology and Obstetrics) indicates an abnormal, pathological adherence or invasion of the placenta. The growing worldwide incidence of this pathological entity, and the possible serious correlated surgical risks, has caused a significant increase in attention among the scientific community. Previous caesarean delivery and presence of placenta previa are the main risk factors for the onset of PAS. Here, we present the intriguing case of a 39-year-old woman, at the 33rd week of gestation, with six previous caesarean sections and with a diagnosis of placenta previa accreta. At our referral center for PAS disorders, we successfully managed this difficult case with the help of a multidisciplinary skilled team.

摘要

国际妇产科联合会(FIGO)引入的胎盘植入(PAS)定义表明胎盘存在异常的病理性粘连或侵入。这种病理实体在全球范围内的发病率不断上升,以及可能伴随的严重手术风险,已引起科学界的高度关注。既往剖宫产史和前置胎盘是发生胎盘植入的主要危险因素。在此,我们介绍一例引人关注的病例,一名39岁女性,孕33周,既往有6次剖宫产史,诊断为植入性前置胎盘。在我们的胎盘植入疾病转诊中心,我们在一个多学科的专业团队帮助下成功处理了这一棘手病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da54/8452425/02e669df7b9b/CRIOG2021-2105248.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da54/8452425/8e5ccc83b8e8/CRIOG2021-2105248.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da54/8452425/9d10ee2cf3f6/CRIOG2021-2105248.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da54/8452425/02e669df7b9b/CRIOG2021-2105248.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da54/8452425/8e5ccc83b8e8/CRIOG2021-2105248.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da54/8452425/9d10ee2cf3f6/CRIOG2021-2105248.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da54/8452425/02e669df7b9b/CRIOG2021-2105248.003.jpg

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本文引用的文献

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Association of hemorrhage at termination in caesarean scar pregnancy using the crossover sign of ultrasound image.超声图像交叉征在剖宫产瘢痕妊娠终止时出血情况中的相关性研究
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早产:单中心人群的七年回顾性研究。
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Ultrasound Obstet Gynecol. 2019 Jun;53(6):752-760. doi: 10.1002/uog.20246. Epub 2019 May 6.
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Early first-trimester transvaginal ultrasound is indicated in pregnancy after previous Cesarean delivery: should it be mandatory?既往剖宫产术后妊娠时,孕早期经阴道超声检查是否必要?
Ultrasound Obstet Gynecol. 2019 Aug;54(2):156-163. doi: 10.1002/uog.20225. Epub 2019 Jul 10.
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FIGO consensus guidelines on placenta accreta spectrum disorders: Introduction.国际妇产科联盟(FIGO)关于胎盘植入谱系疾病的共识指南:引言
Int J Gynaecol Obstet. 2018 Mar;140(3):261-264. doi: 10.1002/ijgo.12406.
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