BACKGROUND Cesarean scar pregnancy(CSP)is rare but may result in uterine rupture during pregnancy or massive hemorrhage during abortion procedures.Awareness of this condition is increasing,and most patients with CSP a...BACKGROUND Cesarean scar pregnancy(CSP)is rare but may result in uterine rupture during pregnancy or massive hemorrhage during abortion procedures.Awareness of this condition is increasing,and most patients with CSP are now diagnosed early and can be managed safely.However,some atypical patients are misdiagnosed,and their surgical risks are underestimated,increasing the risk of fatal hemorrhage.CASE SUMMARY A 27-year-old Asian woman visited our institution because of abnormal pregnancy,and she was diagnosed with a hydatidiform mole through transvaginal ultrasound(TVS).Under hysteroscopy,a large amount of placental tissue was found in the scar of the lower uterine segment,and a sudden massive hemorrhage occurred during the removal process.The bilateral internal iliac arteries were temporarily blocked under laparoscopy,and scar resection and repair were rapidly performed.She was discharged in good condition 5 d after the operation.CONCLUSION Although TVS is widely used in the diagnosis of CSP,delays in the diagnosis of atypical CSP remain.Surgical treatment following internal iliac artery temporary occlusion may be an appropriate management method for unanticipated massive hemorrhage during CSP surgery.展开更多
目的:探讨髂内动脉球囊预置阻断术在植入型凶险性前置胎盘中的临床价值。方法:选取2021年7月—2024年1月阳江市人民医院收治的60例植入型凶险性前置胎盘患者。根据随机数表法将其分为对照组与观察组,各30例。两组均行剖宫产,对照组应用...目的:探讨髂内动脉球囊预置阻断术在植入型凶险性前置胎盘中的临床价值。方法:选取2021年7月—2024年1月阳江市人民医院收治的60例植入型凶险性前置胎盘患者。根据随机数表法将其分为对照组与观察组,各30例。两组均行剖宫产,对照组应用常规止血措施,观察组应用双侧髂内动脉球囊预置术。比较两组围手术期指标、新生儿情况、子宫切除率、并发症。结果:观察组术中出血量少于对照组,手术时间与住院时间均短于对照组,差异有统计学意义(P<0.05)。两组新生儿出生1 min、5 min、10 min Apgar评分比较,差异无统计学意义(P>0.05)。观察组子宫切除率、并发症发生率均低于对照组,差异有统计学意义(P<0.05)。结论:双侧髂内动脉球囊预置术应用于植入型凶险性前置胎盘患者中效果显著,能够减少产妇术中出血量,降低大出血风险,缩短手术时间和住院时间,降低患者子宫切除率与术后并发症发生率。展开更多
目的采用meta分析方法对比远端腹主动脉球囊阻断和双侧髂内动脉球囊阻断在辅助凶险型前置胎盘(PPP)患者剖宫产术的安全性和有效性。方法计算机系统检索中国知网、万方和维普数据库并手工检索PPP预置球囊阻断治疗相关文献,检索时限均自...目的采用meta分析方法对比远端腹主动脉球囊阻断和双侧髂内动脉球囊阻断在辅助凶险型前置胎盘(PPP)患者剖宫产术的安全性和有效性。方法计算机系统检索中国知网、万方和维普数据库并手工检索PPP预置球囊阻断治疗相关文献,检索时限均自建库至2018年8月30日。由2名独立评价者对纳入文献进行质量评价,采用Review Manager 5.0 for Mac软件进行meta分析。结果共有11篇文献纳入分析,结果显示腹主动脉球囊阻断组患者在术中胎儿射线接触量、手术时间、术中出血量、子宫切除率方面优于双侧髂总动脉球囊阻断组,OR(95%CI)分别为-2.57(-2.85^-2.29)、-13.28(-16.56^-10.00)、-0.35(-0.53^-0.17)、0.70(0.50~0.78),P值均<0.05。结论PPP患者剖宫产术中远端腹主动脉球囊阻断技术在术中胎儿射线接触量、总体手术时间、术中出血量和子宫切除率方面优于双侧髂内动脉球囊阻断技术,为临床治疗方式选择提供依据。展开更多
基金Supported by Medical Health Science and Technology Project of Zhejiang Province,China,No.2020ZH003。
文摘BACKGROUND Cesarean scar pregnancy(CSP)is rare but may result in uterine rupture during pregnancy or massive hemorrhage during abortion procedures.Awareness of this condition is increasing,and most patients with CSP are now diagnosed early and can be managed safely.However,some atypical patients are misdiagnosed,and their surgical risks are underestimated,increasing the risk of fatal hemorrhage.CASE SUMMARY A 27-year-old Asian woman visited our institution because of abnormal pregnancy,and she was diagnosed with a hydatidiform mole through transvaginal ultrasound(TVS).Under hysteroscopy,a large amount of placental tissue was found in the scar of the lower uterine segment,and a sudden massive hemorrhage occurred during the removal process.The bilateral internal iliac arteries were temporarily blocked under laparoscopy,and scar resection and repair were rapidly performed.She was discharged in good condition 5 d after the operation.CONCLUSION Although TVS is widely used in the diagnosis of CSP,delays in the diagnosis of atypical CSP remain.Surgical treatment following internal iliac artery temporary occlusion may be an appropriate management method for unanticipated massive hemorrhage during CSP surgery.
文摘目的:探讨髂内动脉球囊预置阻断术在植入型凶险性前置胎盘中的临床价值。方法:选取2021年7月—2024年1月阳江市人民医院收治的60例植入型凶险性前置胎盘患者。根据随机数表法将其分为对照组与观察组,各30例。两组均行剖宫产,对照组应用常规止血措施,观察组应用双侧髂内动脉球囊预置术。比较两组围手术期指标、新生儿情况、子宫切除率、并发症。结果:观察组术中出血量少于对照组,手术时间与住院时间均短于对照组,差异有统计学意义(P<0.05)。两组新生儿出生1 min、5 min、10 min Apgar评分比较,差异无统计学意义(P>0.05)。观察组子宫切除率、并发症发生率均低于对照组,差异有统计学意义(P<0.05)。结论:双侧髂内动脉球囊预置术应用于植入型凶险性前置胎盘患者中效果显著,能够减少产妇术中出血量,降低大出血风险,缩短手术时间和住院时间,降低患者子宫切除率与术后并发症发生率。
文摘目的采用meta分析方法对比远端腹主动脉球囊阻断和双侧髂内动脉球囊阻断在辅助凶险型前置胎盘(PPP)患者剖宫产术的安全性和有效性。方法计算机系统检索中国知网、万方和维普数据库并手工检索PPP预置球囊阻断治疗相关文献,检索时限均自建库至2018年8月30日。由2名独立评价者对纳入文献进行质量评价,采用Review Manager 5.0 for Mac软件进行meta分析。结果共有11篇文献纳入分析,结果显示腹主动脉球囊阻断组患者在术中胎儿射线接触量、手术时间、术中出血量、子宫切除率方面优于双侧髂总动脉球囊阻断组,OR(95%CI)分别为-2.57(-2.85^-2.29)、-13.28(-16.56^-10.00)、-0.35(-0.53^-0.17)、0.70(0.50~0.78),P值均<0.05。结论PPP患者剖宫产术中远端腹主动脉球囊阻断技术在术中胎儿射线接触量、总体手术时间、术中出血量和子宫切除率方面优于双侧髂内动脉球囊阻断技术,为临床治疗方式选择提供依据。
