子宫动脉栓塞术在中期妊娠胎盘前置状态引产中的应用

Applying uterine artery embolization to induction of labor in midpregnancy with placenta previa

目的:探讨子宫动脉栓塞术在中期妊娠胎盘前置状态引产中的应用价值。方法:采用Seldinger技术对10例中期妊娠前置胎盘状态需终止妊娠者进行超选择性双侧子宫动脉栓塞术。同时应用利凡诺尔或米非司酮配伍米索前列醇引产治疗。结果:8例孕妇于栓塞术后19～128 h,平均(64.5±6.43)h娩出胎儿及附属物,术后及产后24 h出血平均(180±14.5)ml。2例孕妇因产前出血多急诊行剖宫产终止妊娠。无1例子宫切除。10例引产后平均(48±3.58)d恢复月经。结论:在中期妊娠胎盘前置状态引产前先行子宫动脉栓塞术是预防和减少出血的一个安全、可行的新途径。

Objective ： To evaluate the efficacy of uterine arterial embolization in induced labor for the pregnant women in mid-trimester with placenta previa. Methods： Using standard Seldinger technique, 10 pregnant women in their mid-trimester with placenta previa required termination of pregnancy underwent super-selection to the uterine artery with gelfoam microspheres embolization and simultaneous induction of labor with ri-vanol or combined mifepristone with misoprostol. Results ： Delivery of the fetus and its accessories achieved after 19 - 128 h （64.5 ± 6.43h） in 8 women, with postoperative and postpartum hemorrhage of 180 ± 14.5 ml on average in 24h, and another 2 required emergency cesarean delivery due to antepartum haemorrhage. The total 10 refused hysterectomy, and regular menstruation occurred on average of 48 ± 3.58 d after the procedure. Conclusion： Pre-operative uterine arterial embolization can make safe induction of labor for pregnant women in their mid-trimester with pla- centa previa and prevent or reduce potential intra-operative bleeding.