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首页> 外文期刊>Case Reports in Obstetrics and Gynecology >Placenta Percreta at 17 Weeks with Consecutive Hysterectomy: A Case Report and Review of the Literature
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Placenta Percreta at 17 Weeks with Consecutive Hysterectomy: A Case Report and Review of the Literature

机译：连续子宫切除术在第17周进行胎盘穿孔的病例报告及文献复习

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Placenta percreta in early pregnancy is an extremely rare but life-threatening complication, for which very few cases have been reported in the literature worldwide, none from the United States. We report a patient with two previous cesarean deliveries, who presented with incomplete abortion at 17 weeks and underwent dilatation and curettage. She was found to have retained, adherent placenta that led to extensive hemorrhage, requiring emergency supracervical hysterectomy. Postoperative course was also complicated by severe consumption coagulopathy, necessitating reexploration after hysterectomy. Pathology revealed a placenta percreta. Patient lost more than 8000 cc blood through the 2 surgeries, received massive transfusions due to severe disseminated intravascular coagulopathy (DIC), and underwent a complicated surgery because of great difficulty in separating lower uterine segment and cervix from the bladder. Abnormal placentation in early pregnancy has increased in prevalence due to marked rise in cesarean deliveries and curettages in recent decades. We reviewed all reported cases of first and second trimester placenta percreta in the literature, to emphasize the early recognition of abnormal placentations in patients with risk factors, consider prenatal evaluation in such patients, anticipate complicated placental implantations during termination procedures, and prevent associated maternal morbidity and mortality.
机译：妊娠早期的胎盘腹膜炎是一种极为罕见但危及生命的并发症，全球文献报道的这种情况很少，美国也没有。我们报告了一位先前有两次剖宫产的患者，他们在17周时出现不完全流产并接受了扩张和刮除术。发现她保留了附着的胎盘，导致大量出血，需要紧急行经子宫子宫切除术。严重的消耗性凝血病也使术后病程复杂化，需要在子宫切除后重新进行检查。病理显示有胎盘分泌物。该患者通过这两次手术损失了8000 cc的血液，由于严重的弥散性血管内凝血病（DIC）而进行了大规模输血，并且由于很难将下子宫段和子宫颈与膀胱分开而进行了复杂的手术。由于最近几十年来剖宫产和刮宫的明显增加，妊娠早期异常胎盘的患病率增加。我们回顾了文献中所有报告的妊娠早期和中期妊娠的胎盘穿孔病例，以强调及早发现具有危险因素的胎盘异常，考虑对这些患者进行产前评估，预期在终止手术期间进行复杂的胎盘植入，并预防相关的母亲发病和死亡率。

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