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本院近10余年来曾发现6例足月宫角妊娠者,产妇年龄25～34岁,平均年龄29岁,孕周37～41周,平均38周,其中初产妇4例,经产妇2例。臀位4例,头位2例。年龄、孕周与其他产妇无明显区别,臀位发生率偏高。3例产妇系臀位手术时发现胎盘不能自娩,宫壁加量注射缩宫素及子宫按摩仍不能娩出,予人工剥离胎盘,发现胎盘位置极高,位于宫角部位,检查宫角呈畸形凸出,表面血管充盈。胎盘剥离顺利,均无胎盘粘连、植入情况。胎盘取出后宫角收缩不良,瘀血肿胀,血管怒张,伴表观颜色改变。与产妇及家属商量后行一侧宫角切除。另3例系阴道分娩后胎盘滞留,产后出血予促宫缩治疗无效,人工剥离胎盘失败(胎盘位置深手不能及),改进腹手术取胎盘,止血时发现。子宫外观及治疗方法如前。此6例产妇均系分娩活婴,Apgar 评分佳。
Our hospital in the past 10 years or so have found 6 cases of full-term pregnancy horn angle, maternal age 25 to 34 years, mean age 29 years, 37 to 41 weeks gestational age, an average of 38 weeks, of which 4 cases of primipara and 2 cases of maternal. 4 cases of breech, head position in 2 cases. Age, gestational age and other maternal no significant difference between the high incidence of breech. 3 cases of maternal breech surgery found that the placenta can not self-delivery, uterine wall injection of oxytocin and uterine massage volume can not be delivered to the artificial dissection of the placenta and found that the placenta is extremely high, located in the corner of the palace, the palace was examined deformity Protruding surface vascular filling. Placental stripping smoothly, no placental adhesion, implantation. Hypothalamic placenta removed poor contraction, blood stasis, blood vessel irritation, with apparent color change. Discuss with the maternal and family side after the line Gong Gong. The other 3 cases of vaginal delivery after the retention of the placenta, postpartum hemorrhage to promote uterine contractions ineffective, artificial placental failure (deep hand and placenta can not), to improve the abdominal surgery to take the placenta, hemostasis found. Uterine appearance and treatment as before. All 6 maternal mothers were delivered live babies with good Apgar scores.