A 40-year-old woman with a history of cesarean section and 3 episodes of uterine curettage for spontaneous or induced abortion presented with massive genital hemorrhage in the ninth week of gestation;she was treated w...A 40-year-old woman with a history of cesarean section and 3 episodes of uterine curettage for spontaneous or induced abortion presented with massive genital hemorrhage in the ninth week of gestation;she was treated with red cell concentrate and fresh frozen plasma transfusion. She was admitted to our hospital at the 11th week of gestation for continuous genital hemorrhage and cervical shortening (20 mm). Ultrasonography revealed placenta previa totalis. A lowlying gestational sac in early pregnancy, vascular lacunae, and an obscured retroplacental sonolucent zone indicated placenta percreta;magnetic resonance imaging showed similar findings. Owing to placenta percreta, uterus preservation was considered impossible. Elective cesarean section followed by total hysterectomy was performed at the 37th week of gestation, with bilateral internal iliac artery balloon catheter occlusion for reducing blood loss. The perioperative blood loss was 2,835 mL, for which the patient received blood transfusion. The postoperative course was uncomplicated.展开更多
A 39-year-old 34-week-pregnant woman was referred to our hospital for preterm labor and fetal dysfunction. Fetal middle cerebral artery systolic maximum blood flow velocity was high, so fetal anemia was suspected. Blo...A 39-year-old 34-week-pregnant woman was referred to our hospital for preterm labor and fetal dysfunction. Fetal middle cerebral artery systolic maximum blood flow velocity was high, so fetal anemia was suspected. Blood type was O-type Rh (+) and fetal hemoglobin was 0.4%;tests for irregular antibody and human parvovirus B19 IgM were negative. A high brightness echoic mass was observed in fetal stomach bubble, and amniotic fluid appeared bright. Labor suppression was disabled, and emergency cesarean section was performed. Amniotic fluid turbidity was observed, and on suctioning the stomach content of the infant, turbid amniotic fluid containing blood was obtained. On placental pathological examination, the cause of bloody amniotic fluid was not identified. The infant’s hemoglobin level was low at 8.7 g/dL, so the infant received red cell concentrate, with improvement of general condition.展开更多
文摘A 40-year-old woman with a history of cesarean section and 3 episodes of uterine curettage for spontaneous or induced abortion presented with massive genital hemorrhage in the ninth week of gestation;she was treated with red cell concentrate and fresh frozen plasma transfusion. She was admitted to our hospital at the 11th week of gestation for continuous genital hemorrhage and cervical shortening (20 mm). Ultrasonography revealed placenta previa totalis. A lowlying gestational sac in early pregnancy, vascular lacunae, and an obscured retroplacental sonolucent zone indicated placenta percreta;magnetic resonance imaging showed similar findings. Owing to placenta percreta, uterus preservation was considered impossible. Elective cesarean section followed by total hysterectomy was performed at the 37th week of gestation, with bilateral internal iliac artery balloon catheter occlusion for reducing blood loss. The perioperative blood loss was 2,835 mL, for which the patient received blood transfusion. The postoperative course was uncomplicated.
文摘A 39-year-old 34-week-pregnant woman was referred to our hospital for preterm labor and fetal dysfunction. Fetal middle cerebral artery systolic maximum blood flow velocity was high, so fetal anemia was suspected. Blood type was O-type Rh (+) and fetal hemoglobin was 0.4%;tests for irregular antibody and human parvovirus B19 IgM were negative. A high brightness echoic mass was observed in fetal stomach bubble, and amniotic fluid appeared bright. Labor suppression was disabled, and emergency cesarean section was performed. Amniotic fluid turbidity was observed, and on suctioning the stomach content of the infant, turbid amniotic fluid containing blood was obtained. On placental pathological examination, the cause of bloody amniotic fluid was not identified. The infant’s hemoglobin level was low at 8.7 g/dL, so the infant received red cell concentrate, with improvement of general condition.
