凶险性前置胎盘伴胎盘植入处理体会

Treatment experience of dangerous placenta previa complicated with placenta accrete

目的:研究凶险性前置胎盘伴胎盘植入的诊断及治疗。方法:收治凶险性前置胎盘并胎盘植入孕妇18例,对其具体情况进行回顾分析。结果:产前彩超胎盘植入时检出率55.55%(10/18),10例行MRI检查,检出率100%(10/10),8例行"8"缝扎剥离面及结扎双侧子宫血管。7例行"8"缝扎剥离面及结扎双侧子宫血管后效果不佳,急行子宫动脉栓塞治疗,保留子宫成功。3例直接行子宫切除。结论:凶险性前置胎盘伴胎盘植入易产后出血,充分术前准备,个体化,多方式治疗,降低并发症。

Objective:To explore the diagnosis and treatment of dangerous placenta previa complicated with placenta accreta. Methods:18 cases of pregnant women with dangerous placenta previa complicated with placenta accreta were selected,the clinical data were retrospectively analyzed.Results:The detection rate of prenatal ultrasound placenta implantation was 55.55%(10/18),10 patients were given MRI examination,the detection rate was 100% (10/10),8 cases were given "8" suture wound surface and bilateral uterine vessel ligation.The effect of "8" suture wound surface and bilateral uterine vessel ligation in 7 cases was poor, they were given emergency uterine artery embolization treatment,uterus was successfully retained.3 patients were given hysterectomy.Conclusion:Postpartum hemorrhage in dangerous placenta previa complicated with placenta accreta was easy to occur,we should have adequate preoperative preparation and individualized treatment in many ways,so as to reduce the complications.