胎盘植入临床病历及文献分析

Analysis of the Clinical Case Gistory and Literature of Placenta Accreta

目的 探讨胎盘植入的高危因素和处理方法。方法 回顾性分析我院 1993～ 2 0 0 2年间 10例胎盘植入病例的特点和处理方法 ,并结合文献加以分析。结果 184 5 6例分娩产妇中 ,胎盘植入 10例 ,发生率为 0 0 5 %。同时合并中央性前置胎盘者 5例。 10例中 3例行子宫次全切除术 ,1例行全子宫切除术。结论 对具有高危因素的孕妇产前综合应用彩超、MRI及血清AFP测定等方法有可能于分娩前诊断胎盘植入。对于术前已明确诊断为大面积、穿透性胎盘植入 ,且无生育要求者 。

Objective We investigate the clinical risk factors and the therapies for placenta accreta.Methods Clinical data of 10 patients with placenta accreta from January 1993 to December 2002 admitted in our obstetrical ward were analyzed retrospectively,and the literature were reviewed.Results 10 of 18456 deliveries (0.05%) were complicated by placenta areta. Among 10 women with placenta accreta, 5 had placenta previa. In three cases subtotal hysterectomy was performed, and one patient underwent hysterectomy.Conclusion It is possible to make antepartum diagnosis if we apply color ultrasound, MRI and AFP in the cases with high risks. When it is placenta percreta widely, the patients also don't want to give birth in the future, we may prepare for the hysterectomy in the delivery or cesearen section.