Multiple gestations have been reported as a risk factor for placenta accreta spectrum (PAS) but the evidence is limited. Previous reports showed that PAS degrees (creta, increta, percreta) were similar in multiple ges...Multiple gestations have been reported as a risk factor for placenta accreta spectrum (PAS) but the evidence is limited. Previous reports showed that PAS degrees (creta, increta, percreta) were similar in multiple gestation placentas. To our knowledge, there have been no reports of PAS in dichorionic placentas with different degrees of invasion. Here, we report dichorionic diamniotic placentas with two different degrees of invasion, one increta and another percreta.展开更多
Purpose: Placenta increta in early pregnancy is rare and has been documented in only few cases and is a complication of pregnancy that can be life threatening for both mother and fetus. Thus early diagnosis of this pr...Purpose: Placenta increta in early pregnancy is rare and has been documented in only few cases and is a complication of pregnancy that can be life threatening for both mother and fetus. Thus early diagnosis of this problem is very important. This problem is a result of inadequate development of the decidua. Case Presentation: A 26 years old woman (gravid 3, para 2) with history of cesarean section for two times, referred to our center with vaginal bleeding with gestational age of 10 weeks and pelvic ultrasonography showed molar or missed pregnancy. The patient was operated by suction curettage. It’s noteworthy to mention that during the procedure sever vaginal bleeding occurred so that total abdominal hysterectomy was done. Histological examination identified placenta increta. Conclusion: In our community, the diagnosis and treatment of placenta accrete in early pregnancy are so crucial and must be taken seriously with considering the fact that the number of repeated cesarean section is high and placenta accreta is one of the most important complication of this method.展开更多
目的:探讨凶险性前置胎盘的围手术期的高危因素及应对策略.方法:对127例凶险性前置胎盘的病例产前出血、术中出血、围手术期出血、子宫切除率、及其他母儿严重并发症进行分析.根据前置胎盘类型分为:中央性前置胎盘组与部分行前置胎盘组...目的:探讨凶险性前置胎盘的围手术期的高危因素及应对策略.方法:对127例凶险性前置胎盘的病例产前出血、术中出血、围手术期出血、子宫切除率、及其他母儿严重并发症进行分析.根据前置胎盘类型分为:中央性前置胎盘组与部分行前置胎盘组.根据术中胎盘剥离情况分为:胎盘植入组、胎盘粘连组及正常剥离组.结果:(1)胎盘植入率:中央组为49.5%,明显高于部分组胎盘植入率23.1%(P<0.05).(2)围手术期出血:中央组平均为1 800 m L,高于部分组平均1 128 m L(P<0.01).胎盘植入组平均2 636 m L,胎盘粘连组平均1 342 m L,胎盘正常剥离组平均822 m L,各组间均有统计学差异(P<0.01).(3)输血情况:胎盘植入组有98.2%患者术后接受输血治疗,平均输血量2 255 m L,胎盘粘连组有88.2%患者接受输血,平均1 267 m L,正常剥离组有53.7%患者接受输血,平均1 165 m L,胎盘植入组明显高于粘连组(P<0.05)及正常剥离组(P<0.01),而粘连组与正常剥离组比较无统计学差异(P>0.05).(4)子宫切除情况:中央组为34.7%,高于部分组15.4%(P<0.05).胎盘植入组为62.5%,明显高于胎盘粘连与正常联合组5.6%(P<0.05).(5)预后:产妇有1例术中出现心脏骤停经抢救预后良好,1例新生儿畸形死亡,其余母儿预后均良好.结论:凶险性前置胎盘胎盘植入率高,合并中央性前置胎盘者,出血是最主要的风险,大量输血准备及果断行子宫切除术是手术成功的关键.展开更多
文摘Multiple gestations have been reported as a risk factor for placenta accreta spectrum (PAS) but the evidence is limited. Previous reports showed that PAS degrees (creta, increta, percreta) were similar in multiple gestation placentas. To our knowledge, there have been no reports of PAS in dichorionic placentas with different degrees of invasion. Here, we report dichorionic diamniotic placentas with two different degrees of invasion, one increta and another percreta.
文摘Purpose: Placenta increta in early pregnancy is rare and has been documented in only few cases and is a complication of pregnancy that can be life threatening for both mother and fetus. Thus early diagnosis of this problem is very important. This problem is a result of inadequate development of the decidua. Case Presentation: A 26 years old woman (gravid 3, para 2) with history of cesarean section for two times, referred to our center with vaginal bleeding with gestational age of 10 weeks and pelvic ultrasonography showed molar or missed pregnancy. The patient was operated by suction curettage. It’s noteworthy to mention that during the procedure sever vaginal bleeding occurred so that total abdominal hysterectomy was done. Histological examination identified placenta increta. Conclusion: In our community, the diagnosis and treatment of placenta accrete in early pregnancy are so crucial and must be taken seriously with considering the fact that the number of repeated cesarean section is high and placenta accreta is one of the most important complication of this method.
文摘目的:探讨凶险性前置胎盘的围手术期的高危因素及应对策略.方法:对127例凶险性前置胎盘的病例产前出血、术中出血、围手术期出血、子宫切除率、及其他母儿严重并发症进行分析.根据前置胎盘类型分为:中央性前置胎盘组与部分行前置胎盘组.根据术中胎盘剥离情况分为:胎盘植入组、胎盘粘连组及正常剥离组.结果:(1)胎盘植入率:中央组为49.5%,明显高于部分组胎盘植入率23.1%(P<0.05).(2)围手术期出血:中央组平均为1 800 m L,高于部分组平均1 128 m L(P<0.01).胎盘植入组平均2 636 m L,胎盘粘连组平均1 342 m L,胎盘正常剥离组平均822 m L,各组间均有统计学差异(P<0.01).(3)输血情况:胎盘植入组有98.2%患者术后接受输血治疗,平均输血量2 255 m L,胎盘粘连组有88.2%患者接受输血,平均1 267 m L,正常剥离组有53.7%患者接受输血,平均1 165 m L,胎盘植入组明显高于粘连组(P<0.05)及正常剥离组(P<0.01),而粘连组与正常剥离组比较无统计学差异(P>0.05).(4)子宫切除情况:中央组为34.7%,高于部分组15.4%(P<0.05).胎盘植入组为62.5%,明显高于胎盘粘连与正常联合组5.6%(P<0.05).(5)预后:产妇有1例术中出现心脏骤停经抢救预后良好,1例新生儿畸形死亡,其余母儿预后均良好.结论:凶险性前置胎盘胎盘植入率高,合并中央性前置胎盘者,出血是最主要的风险,大量输血准备及果断行子宫切除术是手术成功的关键.
