Attieh E, Abboud J, Chalhoub S, Riachi M
Service de Gynécologie-Obstétrique, Hôtel-Dieu de France, Beyrouth, Liban.
J Gynecol Obstet Biol Reprod (Paris). 1993;22(6):649-52.
The authors present two cases of uterine rupture by placenta percreta at 27 and 36 weeks of gestation. Conservative treatment was used in the first case, and radical in the second. Concerning placenta percreta, an overview is presented. The pathophysiology is unclear, but a perturbation in the equilibrium between the trophoblast and the caduque is accepted. Many factors, maternal uterine and placental, contributes to this situation. Clinical presentations are hemorrhage, uterine inversion or rupture. The disappearance of the retroplacental anechogenic zone is the recent ultrasound's contribution to the early diagnosis. The treatment is either radical which is the treatment of choice or conservative and the methotrexate could be an interested option.
作者报告了两例妊娠27周和36周时因胎盘植入穿透子宫肌层导致子宫破裂的病例。第一例采用保守治疗,第二例采用根治性治疗。关于胎盘植入穿透子宫肌层,本文给出了概述。其病理生理学尚不清楚,但滋养层与蜕膜之间平衡的紊乱是公认的。许多因素,包括母体子宫和胎盘因素,都导致了这种情况。临床表现为出血、子宫内翻或破裂。胎盘后无回声区的消失是超声对早期诊断的最新贡献。治疗方法要么是作为首选的根治性治疗,要么是保守治疗,甲氨蝶呤可能是一个值得考虑的选择。