早期妊娠胎盘绒毛植入诊治分析

Diagnosis and treatment of Placenta Accreta in Early Pregnancy

目的总结和探讨早期妊娠胎盘绒毛植入的临床特点、诊治经验。方法回顾性分析2009年1月～2012年6月在我院诊治的6例早期妊娠胎盘绒毛植入的临床资料,总结其诊断和治疗方法。结果 6例患者中4例有停经后表现为不规则阴道流血,3例有剖宫产史,人流吸宫术中发生阴道大量出血,其中2例急诊行开腹子宫病灶切除术,另1例因短时间内大量出血、休克行次全子宫切除术;另外3例早孕人流术后持续不规则阴道流血,血hCG持续不下降,阴道彩超及MRI结果提示绒毛植入给予5-Fu化疗后治愈。结论早孕绒毛植入通常在人流后诊断,依据病史、临床特征结合血hCG、B超及MRI有助诊断,治疗可采取手术治疗及化疗。

Objective To summarize and investigate the clinical characteristics and treatment of placenta accreta in early pregnancy. Methods We retrospectively analyzed the clinical data of 6 patients admitted to Huangjiang Hospital with placenta accreta in early pregnancy from January 2009 to June 2012. Results Among 6 cases,3 cases with the history of cesarean section occurred heavy vaginal bleeding during suction curettage,including 2 cases of emergency uterine lesion resection and the other case shocking subtotal hysterectomy because of severe bleeding in short time;another 3 cases sustaining irregular vaginal bleeding after suction curettage were given 5-Fu chemotherapy and cured because of abnormal blood HCG and results of transvaginal sonography and MRI. Conclusions Placenta accrete in early pregnancy is usually diagnosed after abortion,which based on history,clinical features,blood HCG,B ultrasound and MRI.Operation and chemotherapy were the main therapy of placenta accreta in early pregnancy.