植入性胎盘穿透致子宫破裂2例临床分析

Clinical analysis of 2 cases of uterus rupture caused by placenta percreta.

目的探讨植入性胎盘穿透致子宫破裂的诊断和治疗。方法对近期我院收治的2例植入性胎盘穿透导致子宫破裂的患者的临床资料进行回顾性分析,并复习相关文献。结果2例患者均行急诊剖腹探查术,术中均发现大量腹腔内出血,胎盘植入至子宫浆膜层并导致子宫破裂出血。对两患者分别行次全子宫切除术和子宫楔型切除+修补术,均取得良好治疗效果。结论对有植入性胎盘高危因素的患者应加强产前检查,提高产前诊断率。对可疑患者应尽快行剖腹探查术,术中根据胎盘植入面积大小、失血量多少和是否有生育要求采取不同的治疗方法。

Objective To discuss the diagnosis and management of uterus rupture caused by placenta percreta. Methods The clinical feature of 2 cases of uterus rupture caused by placenta percreta was analyzed, and literature was reviewed. Results Both of the 2 patients were treated with emergency exploratory laparotomy. Both were found having intraperitoneal hemorrhage, placenta perereta and uterine rupture. Subtotal hysterectomy and uterine wedge resection ＆ uterine reparation were done respectively. Conclusion To those high-risk women, prenatal examinations, especially the ultrasound examinations should be emphasized in order to improve the prenatal diagnostic rate. When uterus rupture caused by placenta percreta is suspected, exploratory laparotomy should be done as soon as possible. Different management can be selected according to the size of the placenta percreta, the volume of blood loss, and desire for maintaining reproductive cat, ability.