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首页> 外文期刊>International Journal of Reproduction, Contraception, Obstetrics and Gynecology >Alternative management in a case of placenta accreta with previous caesarean
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Alternative management in a case of placenta accreta with previous caesarean

机译：先前剖腹产导致胎盘积压的替代治疗

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摘要

The rate of caesarean is increasing day by day, and with it the chance of repeat caesarean. This has led to a rise in the chance of occurrence of placenta accreta. Control of bleeding is the main goal in such cases, which usually necessitates hysterectomy. But alternative methods are useful when retaining fertility is important. We present this case of a 30 yr old female who was admitted as a case of central placenta previa with previous caesarean. Per operatively, placenta was attached along the incision and baby was delivered by separating the placenta attached above the upper margin of incision. On attempting to remove the placenta attached to lower part of incision, it was found to be adherent along the previous scar. So placenta was removed piece meal, some part was left behind. Box sutures were taken over that part and uterine packing was done to control the bleeding. Post operatively the patient was fine and given injection Methotrexate on 8th day following the regime of 1, 3, 5, 7 days. She failed to expulse the placenta by 6wks, so D&E was done and retained products were removed. Leaving the placenta in situ followed by Methotrexate and interval removal of placenta can thus be helpful in conserving the uterus and hence, the fertility.
机译：剖腹产的比率每天都在增加，并且有重复剖腹产的机会。这导致胎盘积聚发生的机会增加。在这种情况下，控制出血是主要目标，通常需要进行子宫切除术。但是，在保持生育力很重要的情况下，替代方法很有用。我们介绍了此例，该例为一名30岁的女性，该女性被纳入前胎盘剖宫产的前置中央胎盘。手术中，胎盘沿切口附着，婴儿通过分离附着在切口上缘上方的胎盘而分娩。试图去除附着在切口下部的胎盘时，发现它附着在先前的疤痕上。因此胎盘被去除了一餐，留下了一部分。将盒子缝合在该部分上，并进行子宫包装以控制出血。术后患者情况良好，在治疗1、3、5、7天后的第8天注射甲氨蝶呤。她未能将胎盘驱逐出6周，因此进行了D＆E，并去除了残留的产品。因此，将胎盘留在原位，然后再进行甲氨蝶呤和间隔移出胎盘，有助于保护子宫，从而保护生育能力。

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