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目的进一步探讨胎盘植入发生的高危因素及其诊断和处理方法。方法回顾性分析南昌市第二医院2004年1月至2008年12月12例胎盘植入患者资料。结果12例患者中,3例子宫切除,9例保守治疗;产后出血>1000ml者8例,无产妇死亡;除1例引产外,11例新生儿均存活。所有患者均治愈。结论种植部位的子宫内膜缺损或发育不良,导致绒毛直接种植于子宫肌层;多次刮宫、剖宫产、前置胎盘是胎盘植入的高危因素。应用彩色多普勒、能量多普勒、磁共振成像(magnetic resonance imaging,MRI)能提高产前诊断率。治疗胎盘植入的方法包括子宫切除和保留子宫保守治疗。
Objective To investigate the risk factors of placenta accreta and its diagnosis and treatment. Methods The data of 12 patients with placenta accreta from January 2004 to December 2008 in the Second Hospital of Nanchang were retrospectively analyzed. Results Among the 12 patients, 3 cases were treated by hysterectomy and 9 cases were conservative treatment. There were 8 cases with postpartum hemorrhage more than 1000 ml, and no maternal death was found. All the 11 newborns survived except 1 case of induced labor. All patients were cured. Conclusion The implantation site of endometrial defects or dysplasia, resulting in villi directly implanted in the myometrium; multiple curettage, cesarean section, placenta previa is placenta accreta risk factors. Application of color Doppler, energy Doppler, magnetic resonance imaging (MRI) can increase the rate of prenatal diagnosis. Methods of treating placenta accreta include hysterectomy and preserving uterine conservative treatment.