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目的探讨子宫动脉栓塞术在中孕胎盘前置状态引产中的应用。方法 8例中孕引产合并胎盘前置状态患者为研究对象,超声检查提示胎盘完全覆盖宫颈内口,采用利凡诺羊膜腔内引产联合子宫动脉栓塞术,回顾性分析其疗效及术后并发症。结果 8例患者均引产成功,无产后出血及晚期产后出血病例发生。8例患者术后均因下腹部疼痛需用止痛药治疗。有5例患者于子宫动脉栓塞术后出现发热,胎儿及胎盘娩出后体温渐恢复正常,无产褥感染病例。6例患者考虑胎膜残留需行清宫术。产后42 d复查妇科彩超均未见异常,月经恢复时间35~62 d。结论对于中孕引产合并胎盘前置状态、尤其是胎盘完全覆盖宫颈内口的患者,子宫动脉栓塞术降低了产时产后出血风险,而且,子宫动脉栓塞术具有创伤小、并发症少等优点,值得临床应用和推广。
Objective To investigate the application of uterine arterial embolization in the induction of labor in the anterior placenta of the second trimester. Methods Eight pregnant women with induced placenta previa and induced labor were enrolled in this study. Ultrasonography revealed that the placenta completely covered the internal orifice of the cervix. Rivinoxavar combined with uterine artery embolization was used to evaluate the efficacy and postoperative complications . Results All the 8 patients were successful in inducing labor, with no postpartum hemorrhage and late postpartum hemorrhage. All 8 patients were treated with painkillers because of lower abdominal pain. Five patients developed fever after uterine artery embolization. The temperature of the fetus and placenta returned to normal gradually without any puerperal infection. 6 patients with residual membranes need to curettage. 42 days postpartum gynecological ultrasound examination showed no abnormalities, menstruation recovery time 35 ~ 62 d. Conclusion Uterine artery embolization can reduce the risk of postpartum hemorrhage during the prenatal pregnancy combined with placenta previa, especially when the placenta completely covers the mouth of the cervix. Moreover, uterine artery embolization has the advantages of less trauma and fewer complications, Worthy of clinical application and promotion.