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植入性胎盘是指胎盘全部或部分植入子宫肌层、浆膜层,甚至穿破子宫。这是由于子宫蜕膜层发育不良或完全缺如,胎盘绒毛直接植入子宫肌壁所致。临床上较少见,常误诊为胎盘滞留、粘连而强行徒手剥离,导致子宫穿孔和致命性出血,如处理不及时或不恰当,可造成严重后果。笔者自1975年3月～1979年4月,收治植入性胎盘5例,均在抢救失血性休克中行子宫切除术,无一例死亡,现报告如下。一、病历摘要(见下页附表) 二、病因多有宫腔创伤史。 (一)刮宫史1、2、4、5例均有人工流产、自然流产或产后刮宫史。 (二)人工剥离胎盘术及出血史1、4、5例均有人工剥离胎盘史及产后失血性休克史,且例4有连续
Implantable placenta refers to all or part of the placenta implanted in the myometrium, serosa, and even the uterus. This is due to dysplastic uterine deciduation or complete absence of placental villi directly implanted in the uterine muscle wall. Clinically rare, often misdiagnosed as placental retention, adhesions and forced hand stripping, leading to uterine perforation and fatal bleeding, such as handling is not timely or inappropriate, can have serious consequences. The author from March 1975 to April 1979, admitted placenta accreta in 5 cases, rescue hemorrhagic shock line hysterectomy, without a death, are as follows. First, a summary of medical records (see the attached table on the following page) Second, the etiology and more history of uterine trauma. (A) curettage history 1,2,4,5 cases have induced abortion, spontaneous abortion or postpartum curettage history. (B) the history of manual dissection placenta accreta and bleeding 1, 4 and 5 cases of artificial placental exfoliation history and postpartum hemorrhagic shock history, and Example 4 continuous