妊娠18周时诊断为植入性前置胎盘。一例超声与病理对照的病例报告。
Placenta previa increta diagnosed at 18 weeks' gestation. Report of a case with sonographic and pathologic correlation.
作者信息
Wheeler T C, Anderson T L, Kelly J, Boehm F H
机构信息
Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN 37232-2519, USA.
出版信息
J Reprod Med. 1996 Mar;41(3):198-200.
BACKGROUND
Placenta previa incerta, although uncommon, assumes considerable clinical significance because of the morbidity associated with severe hemorrhage, uterine perforation and infection. The majority of cases are unanticipated and initially identified intraoperatively.
CASE
Placenta accreta was diagnosed sonographically at 18 weeks' gestation in a multipara who had previously undergone cesarean delivery. Additionally, the gestation was complicated by chronic renal failure secondary to systemic lupus erythematosus. After appropriate counseling, total abdominal hysterectomy was performed prior to fetal viability.
CONCLUSION
Early sonographic evaluation of the placenta is recommended for those at significant risk of invasive placentation. Timely detection facilitates proper preparation and should reduce maternal morbidity.
背景
前置胎盘类型不明虽不常见，但因其与严重出血、子宫穿孔及感染相关的发病率，具有相当大的临床意义。大多数病例是意外情况，最初在手术中发现。
病例
一名有剖宫产史的经产妇在妊娠18周时经超声诊断为胎盘植入。此外，该妊娠合并系统性红斑狼疮继发的慢性肾衰竭。经过适当的咨询后，在胎儿具有存活能力之前进行了全腹子宫切除术。
结论
对于有侵袭性胎盘植入重大风险的人群，建议早期对胎盘进行超声评估。及时检测有助于做好适当准备，并应降低孕产妇发病率。
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