We present our own experience management in pregnant women with placenta percreta. For the timely diagnosis of placenta accreta or placenta percreta, it is recommended to conduct ultrasound and Magnetic Resonance Imag...We present our own experience management in pregnant women with placenta percreta. For the timely diagnosis of placenta accreta or placenta percreta, it is recommended to conduct ultrasound and Magnetic Resonance Imaging (MRI) studies in women with placenta previa and a history of caesarean section. Objective signs of placenta accreta, identified before delivery, make it possible to make the right decision about delivery and minimize complications in the mother and newborn. A coordinated interdisciplinary approach to these complex cases and early resuscitation with blood products are critical factors in the successful management of patients affected by this disease.展开更多
目的:探讨选择性血管阻断技术在妊娠晚期穿透性胎盘治疗中应用的价值。方法:回顾性分析2003年1月至2010年12月中南大学湘雅医院明确诊断的孕龄≥34周的15例穿透性胎盘患者的临床资料。根据患者是否使用血管阻断技术,分为血管阻断组(n=8...目的:探讨选择性血管阻断技术在妊娠晚期穿透性胎盘治疗中应用的价值。方法:回顾性分析2003年1月至2010年12月中南大学湘雅医院明确诊断的孕龄≥34周的15例穿透性胎盘患者的临床资料。根据患者是否使用血管阻断技术,分为血管阻断组(n=8)与血管未阻断组(n=7);血管阻断组按血管阻断技术应用的时机,又分为预防性应用组(n=4)和治疗性应用组(n=4,其中1例为髂总动脉球囊取出后)。比较血管阻断组与血管未阻断组出血量、子宫切除率及并发症发生情况。结果:15例穿透性胎盘患者术中平均出血量为3813 mL,子宫切除率为73.3%(11/15),近期并发症发生率为20.0%(3/15,包括2例凝血功能障碍和1例下肢血栓形成),远期并发症的发生率为0;其中血管阻断组平均出血量为2512 mL,子宫切除率为62.5%(5/8);血管未阻断组平均出血量5549 mL,子宫切除率85.7%(6/7);两组平均出血量及子宫切除率相比差异均有统计学意义(P<0.05)。且预防性应用组的平均出血量和子宫切除率亦显著低于治疗性应用组(1350 mL vs 3600 mL,60.0%vs 66.7%,P<0.05)。结论:穿透性胎盘患者术中出血量大,子宫切除率高;选择性血管阻断技术可减少其出血量,降低子宫切除率,但仍有严重出血以及切除子宫的风险。展开更多
文摘We present our own experience management in pregnant women with placenta percreta. For the timely diagnosis of placenta accreta or placenta percreta, it is recommended to conduct ultrasound and Magnetic Resonance Imaging (MRI) studies in women with placenta previa and a history of caesarean section. Objective signs of placenta accreta, identified before delivery, make it possible to make the right decision about delivery and minimize complications in the mother and newborn. A coordinated interdisciplinary approach to these complex cases and early resuscitation with blood products are critical factors in the successful management of patients affected by this disease.
文摘目的:探讨选择性血管阻断技术在妊娠晚期穿透性胎盘治疗中应用的价值。方法:回顾性分析2003年1月至2010年12月中南大学湘雅医院明确诊断的孕龄≥34周的15例穿透性胎盘患者的临床资料。根据患者是否使用血管阻断技术,分为血管阻断组(n=8)与血管未阻断组(n=7);血管阻断组按血管阻断技术应用的时机,又分为预防性应用组(n=4)和治疗性应用组(n=4,其中1例为髂总动脉球囊取出后)。比较血管阻断组与血管未阻断组出血量、子宫切除率及并发症发生情况。结果:15例穿透性胎盘患者术中平均出血量为3813 mL,子宫切除率为73.3%(11/15),近期并发症发生率为20.0%(3/15,包括2例凝血功能障碍和1例下肢血栓形成),远期并发症的发生率为0;其中血管阻断组平均出血量为2512 mL,子宫切除率为62.5%(5/8);血管未阻断组平均出血量5549 mL,子宫切除率85.7%(6/7);两组平均出血量及子宫切除率相比差异均有统计学意义(P<0.05)。且预防性应用组的平均出血量和子宫切除率亦显著低于治疗性应用组(1350 mL vs 3600 mL,60.0%vs 66.7%,P<0.05)。结论:穿透性胎盘患者术中出血量大,子宫切除率高;选择性血管阻断技术可减少其出血量,降低子宫切除率,但仍有严重出血以及切除子宫的风险。
