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产后产科并发症:放射科医生指南

Postpartum obstetric complications: a guide for radiologists.

作者信息

Barrios-López Marta, Sánchez-Bernal Sara, Julián Gómez Elena, Galante María José, Herrán de la Gala Darío, González-Sánchez Francisco José, Fernández-Flórez Alejandro, Barba-Arce Ana, González-Carreró Carmen

机构信息

Department of Radiology, Hospital Universitario Marqués de Valdecilla, Av Valdecilla S/N, 39008, Santander, Spain.

Department of Radiology, Hospital Clínico Universitario de Salamanca, P San Vicente 182, 37007, Salamanca, Spain.

出版信息

Abdom Radiol (NY). 2025 Jan;50(1):513-527. doi: 10.1007/s00261-024-04445-y. Epub 2024 Aug 1.

DOI:10.1007/s00261-024-04445-y
PMID:39088017
Abstract

The puerperium refers to the 6-8 weeks following delivery, and is a dynamic period in which maternal anatomy and physiology are restored to their prepregnant state. Postpartum complications can be divided into non-obstetric and obstetric. The latter are the topic of this article and can be further classified as infectious, thrombotic, hemorrhagic or cesarean-related. Transvaginal US is often the initial modality in the evaluation of puerperal disorders. CT is probably the most valuable imaging technique when life-threatening conditions are suspected. Pelvic MRI is being increasingly used in cases of inconclusive findings or if further characterization is needed, especially in the setting of postsurgical complications or placental disorders. Diagnostic and interventional radiologists play a pivotal role in the evaluation and management of a variety of puerperal complications. Many of these conditions pose a diagnostic challenge, as imaging findings often overlap with normal postpartum changes, so keeping in mind the patient's clinical information is key.

摘要

产褥期是指分娩后的6至8周,是一个动态时期,在此期间产妇的解剖结构和生理机能会恢复到孕前状态。产后并发症可分为非产科并发症和产科并发症。本文的主题是后者,可进一步分为感染性、血栓性、出血性或剖宫产相关并发症。经阴道超声检查通常是评估产褥期疾病的初始检查方法。当怀疑存在危及生命的情况时,CT可能是最有价值的成像技术。在检查结果不明确或需要进一步定性时,尤其是在术后并发症或胎盘疾病的情况下,盆腔MRI的应用越来越广泛。诊断和介入放射科医生在各种产褥期并发症的评估和管理中起着关键作用。其中许多情况都带来了诊断挑战,因为影像学表现往往与正常产后变化重叠,所以牢记患者的临床信息是关键。

相似文献

1
Postpartum obstetric complications: a guide for radiologists.产后产科并发症:放射科医生指南
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本文引用的文献

1
Management of Postpartum Haemorrhage.产后出血的管理
Turk J Anaesthesiol Reanim. 2022 Dec;50(6):396-402. doi: 10.5152/TJAR.2022.21438.
2
Pelvic ultrasonography of the postpartum uterus in patients presenting to the emergency room with vaginal bleeding and pelvic pain.对因阴道出血和盆腔疼痛而到急诊室就诊的患者进行产后子宫的盆腔超声检查。
Ultrasonography. 2022 Oct;41(4):782-795. doi: 10.14366/usg.22004. Epub 2022 Apr 8.
3
The accuracy of contrast-enhanced computed tomography scans to detect postpartum haemorrhage: an observational study.
对比增强计算机断层扫描在产后出血检测中的准确性:一项观察性研究。
BMC Pregnancy Childbirth. 2022 Jan 25;22(1):67. doi: 10.1186/s12884-021-04306-2.
4
Postpartum hemorrhage - what the interventional radiologist should know.产后出血——介入放射科医生应了解的内容。
CVIR Endovasc. 2021 Dec 13;4(1):86. doi: 10.1186/s42155-021-00277-9.
5
Sonographic findings in acute puerperal endometritis.急性产褥期子宫内膜炎的超声检查结果
Australas J Ultrasound Med. 2018 Sep 7;21(4):234-240. doi: 10.1002/ajum.12112. eCollection 2018 Nov.
6
Refractory uterine atony: still a problem after all these years.难治性子宫乏力:多年后仍是一个问题。
Int J Obstet Anesth. 2021 Nov;48:103207. doi: 10.1016/j.ijoa.2021.103207. Epub 2021 Jul 21.
7
Trends and projections of caesarean section rates: global and regional estimates.剖宫产率的趋势和预测:全球和区域估计。
BMJ Glob Health. 2021 Jun;6(6). doi: 10.1136/bmjgh-2021-005671.
8
Risk Factors for Atonic Postpartum Hemorrhage: A Systematic Review and Meta-analysis.产后宫缩乏力性出血的危险因素:系统评价和荟萃分析。
Obstet Gynecol. 2021 Feb 1;137(2):305-323. doi: 10.1097/AOG.0000000000004228.
9
Risks factors FOR wound complications after cesarean section.剖宫产术后伤口并发症的风险因素。
J Gynecol Obstet Hum Reprod. 2021 Sep;50(7):101987. doi: 10.1016/j.jogoh.2020.101987. Epub 2020 Nov 16.
10
ACR Appropriateness Criteria® Postpartum Hemorrhage.美国放射学会适宜性标准®产后出血
J Am Coll Radiol. 2020 Nov;17(11S):S459-S471. doi: 10.1016/j.jacr.2020.09.011.