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[植入性胎盘前置与产科子宫切除术]

[Placenta praevia accreta and obstetric hysterectomy].

作者信息

de Nadal M, Saludes J, López M V, Miranda L

机构信息

Servicio de Anestesiología y Reanimación, Hospital Universitari Materno-Infantil Vall d'Hebron, Barcelona.

出版信息

Rev Esp Anestesiol Reanim. 1995 Apr;42(4):145-7.

PMID:7784688
Abstract

We present the case of a 38-years-old tertipara at full term with a diagnosis by ultrasound of placenta previa who underwent elective cesarean under spinal anesthesia. After a difficult birth, anomalous adhesion of the placenta prevented its removal and caused massive hemorrhage of the placental bed and hypovolemic shock. Blood volume was restored and emergency hysterectomy under general anesthesia was effected, as bleeding and hemodynamic state were brought under control. Abnormal heart rhythm appearing after the operation responded to treatment; postoperative recovery was unremarkable. Placenta accreta is a rare complication of placenta previa. Given that massive obstetric hemorrhage is associated with significant mortality and morbidity, both maternal and fetal, the anesthesiologist must be aware of potential problems that might arise in cases of placental accreta so that readiness can keep risk to a minimum.

摘要

我们报告一例38岁足月三产妇病例,超声诊断为前置胎盘,在脊麻下行择期剖宫产。分娩困难,胎盘异常粘连,无法娩出,导致胎盘床大量出血和低血容量性休克。在出血和血流动力学状态得到控制后,恢复血容量,并在全身麻醉下实施了急诊子宫切除术。术后出现的心律失常经治疗后好转;术后恢复情况良好。胎盘植入是前置胎盘的一种罕见并发症。鉴于产科大出血会导致母婴严重的死亡率和发病率,麻醉医生必须意识到胎盘植入病例中可能出现的潜在问题,以便做好准备将风险降至最低。

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