CAJ | 학술논문

目的：探讨子宫动脉栓塞术联合利凡诺在完全性前置胎盘状态引产中的应用价值。方法采用Seldinger技术对35例中晚期妊娠完全性前置胎盘状态需要终止妊娠者进行超选择性双侧子宫动脉栓塞术。同时应用利凡诺尔和米非司酮引产治疗。结果29例孕妇于栓塞术后10~132h，平均(32.5±5.53)h娩出胎儿及附属物，术后及产后24h出血平均(198±13.5)mL。5例孕妇因产前出血多急诊行剖宫产终止妊娠。1例介入后立即剖宫取胎。无1例子宫切除。35例引产后平均(46±3.45)d恢复月经。结论在中晚期妊娠完全性前置胎盘状态引产前先行子宫动脉栓塞术是预防和减少出血的一个安全、可行的新途径。
목적：탐토자궁동맥전새술연합리범낙재완전성전치태반상태인산중적응용개치。방법채용Seldinger기술대35례중만기임신완전성전치태반상태수요종지임신자진행초선택성쌍측자궁동맥전새술。동시응용리범낙이화미비사동인산치료。결과29례잉부우전새술후10~132h，평균(32.5±5.53)h면출태인급부속물，술후급산후24h출혈평균(198±13.5)mL。5례잉부인산전출혈다급진행부궁산종지임신。1례개입후립즉부궁취태。무1례자궁절제。35례인산후평균(46±3.45)d회복월경。결론재중만기임신완전성전치태반상태인산전선행자궁동맥전새술시예방화감소출혈적일개안전、가행적신도경。
Objective To evaluate the efficacy of combination application of uterine artery embolization and rivanol in induced abortion with complete placenta previa in the second and third trimester pregnancy. Methods Using standard seldinger technique, 35 pregnant women in their second and third trimester pregnancy with complete placenta previa required termination of pregnancy underwent super-selection to the uterine artery with gelfoam microspheres embolization and simultaneous induction of labor with rivanol combined with mifepristone. Results Delivery of the fetus and its accessories achieved after 10-132h (32.5±5.53)h in 29 women, with postoperative and postpartum hemorrhage of (198±13.5)mL on average in 24h, and another 5 required emergency cesarean delivery due to antepartum haemorrhage. One case required emergency cesarean after uterine artery embolization. The total 35 refused hysterectomy, and regular menstruation occurred on average of (46±3.45)d after the procedure. Conclusion Pre-operative uterine arterial embolization can make safe induction of labor for pregnant women in their second and third trimester pregnancy with complete placenta previa and prevent or reduce potential intra-operative bleeding.