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胎盘植入谱系疾病的管理挑战及资源有限环境下的应对方法——病例报告

Management challenges of placenta accreta spectrum and a way forward in a resource limited setting - a case report.

作者信息

Dorji Namkha, Dorji Phurb, Pelden Tshering, Tshering Sangay

机构信息

Department of Obstetrics and Gynaecology, Jigme Dorji Wangchcuk National Referral Hospital, Thimphu, Bhutan; Faculty of Postgraduate Medicine, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan.

Kidu Medical Unit, Thimphu, Bhutan.

出版信息

Int J Surg Case Rep. 2025 Aug;133:111644. doi: 10.1016/j.ijscr.2025.111644. Epub 2025 Jul 9.

Abstract

INTRODUCTION AND IMPORTANCE

Placenta accreta spectrum (PAS) is a serious long-term complication of cesarean section, which may be associated with massive bleeding or mortality. This case report high lights the management challenges of PAS in a low resource setting, and explores the potential way forward.

CASE PRESENTATION

A 34-year-old woman with a history of two previous cesarean section was diagnosed with placenta previa major with placenta accreta spectrum at 28 weeks of pregnancy. She underwent emergency classical cesarean section at 32 weeks, followed by peri-partum total abdominal hysterectomy with bladder injury repair.

DISCUSSION

PAS is a serious complication of cesarean section. Antenatal diagnosis and management by a dedicated PAS team will significantly improve patient outcomes.

CONCLUSION

This case report high lights the importance of raising awareness among obstetrician and other health care providers about risks, management, and complications associated with PAS, and the requirement of institutions to have a PAS team.

摘要

引言与重要性

胎盘植入谱系疾病(PAS)是剖宫产的一种严重远期并发症,可能导致大量出血或死亡。本病例报告突出了在资源匮乏地区PAS的管理挑战,并探索了未来的潜在解决途径。

病例介绍

一名34岁有两次剖宫产史的女性,在妊娠28周时被诊断为完全性前置胎盘合并胎盘植入谱系疾病。她在32周时接受了急诊古典式剖宫产,随后进行了围产期全腹子宫切除术并修复膀胱损伤。

讨论

PAS是剖宫产的严重并发症。由专业的PAS团队进行产前诊断和管理将显著改善患者预后。

结论

本病例报告突出了提高产科医生和其他医疗服务提供者对PAS相关风险、管理及并发症的认识的重要性,以及机构配备PAS团队的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/377f/12275465/49ed8bc4e5be/gr1.jpg

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