MRI、B超对中期妊娠合并胎盘植入的诊断价值
摘要
胎盘植入是造成产后出血、孕产妇死亡的严重产科合并症,近年来已经成为产后出血、子宫切除的主要指征。在中期引产时,胎盘植入同样存在导致产妇出血的风险。本文综述了胎盘植入的流行病学、病因学、MRI及B超对其的诊断价值、依据影像学检查制定其治疗的方法。治疗包括手术治疗及药物治疗。手术治疗包括B超指导下钳刮术、开腹局部病灶切除术、宫腔镜下局部病灶切除术、经导管动脉栓塞术、子宫切除术等。在产前就要密切关注孕妇是否有胎盘植入的高危因素,仔细的产前检查和引产时对胎盘植入临床特点的关注,通过影像学尽早做出胎盘植入的诊断,采取保守的手术及药物治疗方法,减少产时产后的出血量,尽可能保全妇女的生育能力。
引文
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[14]张力,李萍,何国琳,等.经腹彩色超声多普勒在前置胎盘并发胎盘植入诊断中的价值[J].中华妇产科杂志,2006,41(12):799-783.
[15]彭软,谢红宁,杨建波,等.胎盘植入的产前超声诊断及其影响因素研究[J].中国临床医学影像杂志,2010,21(1):67-71.
[16]Timor-Tritsch IE,Monteagudo A.Unforeseen consequences of the increasing rate of cesarean deliveries:early placenta accreta and cesarean scar pregnancy:a review[J].Am J Obstet Gynecol,2012,207(1):10-14.
[17]王蕴慧.中期妊娠引产胎盘前置的处理[J].中国实用妇科与产科杂志,2012,28(9):663-666.
[18]张园,孙多成,徐林,等.胎盘植入的MRI诊断价值[J].实用医学杂志,2013,29(20):3401-3403.
[2]Konijeti R,Rajfer J,Askari A.Placenta percreta and the urologist[J].Rev Urol,2009,11(3):173-176.
[3]张超,刘欣燕,范光升,等.中晚期妊娠胎盘植入患者的临床分析[J].中华妇产科杂志,2008,43(7):506-511.
[4]Fitzpatrick K E,Sellers S,Spark P,et al.Incidence andrisk factors for placenta accreta/increta/percreta in the UK:a national case-control study[J].PLoS ONE,2012,7(12):e52893.
[5]Marshall NE,Fu R,Guise JM.Impact of multiple cesarean deliverises on maternal morbidity:a systematic review[J].Am J Obstet Gynecol,2011,205(3):262.
[6]肖中苏,谢建平.前置胎盘、胎盘粘连、胎盘植入与人工流产的关系[J].实用预防医学,2007,14(6):1831-1832.
[7]周莉,吴连方.40例植入性胎盘的回顾性分析[J].首都医科大学学报,2005,26(1):90-94.
[8]Tseng J J,Chou M M,Hsieh Y T,et al.Differential expressionof vascular endothelial growth factor,placenta growth factor and their receptors in placentae from pregnancies complicated by placenta accrete[J].Placenta,2006,27(1):70-78.
[9]Beuker J M,Erwich J J,Khong T Y.Is endomyometrial injury during termination of pregnancy or curettage following miscarriage the precursor to placenta accreta?[J].Clin Pathol,2005,58(3):273-275.
[10]Kadasne A R,Mirghani H M.The role of ultrasound in lifethreatening situations in pregnancy[J].Emerg Trauma hock,2011,4(4):508-510.
[11]Comstock C H.Antenatal diagnosis of placenta accreta:a review[J].Ultrasound Obstet Gynecol,2005,26(1):89-96.
[12]杨洁,徐莉,陈敦金,等.彩超和磁共振成像诊断胎盘植入价值的评价[J].现代妇产科进展,2008,17(7):530-532.
[13]Dwyer B K,Belogolovkin V,Tran L,et al.Prenatal diagnosis of placenta accreta:sonography or magnetic resonance imaging?[J].J Ultrasound Med,2008,27(9):1275-1281.
[14]张力,李萍,何国琳,等.经腹彩色超声多普勒在前置胎盘并发胎盘植入诊断中的价值[J].中华妇产科杂志,2006,41(12):799-783.
[15]彭软,谢红宁,杨建波,等.胎盘植入的产前超声诊断及其影响因素研究[J].中国临床医学影像杂志,2010,21(1):67-71.
[16]Timor-Tritsch IE,Monteagudo A.Unforeseen consequences of the increasing rate of cesarean deliveries:early placenta accreta and cesarean scar pregnancy:a review[J].Am J Obstet Gynecol,2012,207(1):10-14.
[17]王蕴慧.中期妊娠引产胎盘前置的处理[J].中国实用妇科与产科杂志,2012,28(9):663-666.
[18]张园,孙多成,徐林,等.胎盘植入的MRI诊断价值[J].实用医学杂志,2013,29(20):3401-3403.