子宫动脉栓塞预防孕中期胎盘位置异常及胎盘植入终止妊娠时大出血的疗效分析

Efficacy of prophylactic uterine artery embolization on mid-term pregnancy placental site abnormalities and high risk of massive bleeding because of placenta accreta

目的评价预防性子宫动脉栓塞预防孕中期胎盘位置异常及胎盘植入患者终止妊娠时大出血的安全性和有效性。方法回顾性分析2014年6月—2017年6月于我院介入中心因孕中期胎盘位置异常及胎盘植入接受预防性子宫动脉栓塞的26例患者资料,对所有患者均进行预防性子宫动脉栓塞治疗,总结临床资料,介入治疗并发症情况及随访情况,分析其安全性和有效性。结果对26例患者均行双侧子宫动脉栓塞,技术成功率为100%,无介入相关严重并发症发生。所有患者于子宫动脉栓塞后均成功终止妊娠,无一例发生大出血,所有患者均成功保留子宫。随访期间有1例患者月经过多持续半年,2例患者月经过少持续5个月,有2例患者再次自然怀孕。结论预防性子宫动脉栓塞是预防孕中期胎盘位置异常及胎盘植入终止妊娠时大出血的一种微创、安全、有效的方法。

Objective To evaluate the safety and efficacy of prophylactic uterine artery embolization （UAE） on mid - term pregnancy placental site abnormalities and massive bleeding because of placenta accreta. Methods Twenty-six patients with prophylactic UAE due to abnormal placental position during pregnancy and placental implantation in our hospital intervention center from Jun 2014 to Jun 2017 were retrospectively analyzed. All patients were treated with prophylactic uterine artery embolization. The clinical data, interventional treatment, complications and follow-up were summarized, and the safety and efficacy of UAE were analyzed. Results Twenty-six patients underwent bilateral uterine artery embolization, the technical success rate was 100%. No major complications related to intervention occurred. All patients were successfully terminated pregnancy after uterine artery embolization. No one had massive bleeding, and all patients were successfully retained the uterus. During the follow-up period, menometrorrhagia was found in a patient for more than six months, and oligomenorrhea was found in 2 patients for five months, and two patients were naturally pregnant again. Conclusion Prophylactic UAE before an obstetrical procedure is a safe and effective way to manage or prevent midterm pregnancy of placental site abnormalities and massive bleeding of placenta accreta.