CAJ | 학술논문

目的：探讨子宫动脉栓塞术用于中央性前置胎盘中晚期妊娠引产的可行性及疗效。方法南昌大学第一附属医院于2009年1月~2013年6月对18例中央性前置胎盘中晚期妊娠要求引产的患者行超选择性双侧子宫动脉栓塞术(A组)，观察并分析其分娩方式、阴道出血量及并发症，以同期25例中央性前置胎盘患者直接行剖宫取胎术作对照组(B组)。结果 A组18例行子宫动脉栓塞术患者中，15例经阴道分娩，其中有1例合并严重宫腔感染，1例因胎盘植入改行全子宫切除术，另3例因阴道流血多转行剖宫取胎术；B组25例直接行剖宫取胎术者，平均出血780ml，有5例行全子宫切除术，显著高于A组。结论子宫动脉栓塞术用于中央性前置胎盘中晚期妊娠引产安全、有效、微创，但应谨慎选择孕周、结合B超或MRI排除胎盘植入可能。
목적：탐토자궁동맥전새술용우중앙성전치태반중만기임신인산적가행성급료효。방법남창대학제일부속의원우2009년1월~2013년6월대18례중앙성전치태반중만기임신요구인산적환자행초선택성쌍측자궁동맥전새술(A조)，관찰병분석기분면방식、음도출혈량급병발증，이동기25례중앙성전치태반환자직접행부궁취태술작대조조(B조)。결과 A조18례행자궁동맥전새술환자중，15례경음도분면，기중유1례합병엄중궁강감염，1례인태반식입개행전자궁절제술，령3례인음도류혈다전행부궁취태술；B조25례직접행부궁취태술자，평균출혈780ml，유5례행전자궁절제술，현저고우A조。결론자궁동맥전새술용우중앙성전치태반중만기임신인산안전、유효、미창，단응근신선택잉주、결합B초혹MRI배제태반식입가능。
Objective To evaluate the ef icacy and safety of uterine arterial embolization in induced labor for pregnant women with complete placenta praevia. Methods A total of 18 pregnant women in their mid-or third-trimester with placenta praevia requiring termination of pregnancy in our department between January 2009 and June 2013 underwent the uterine bi-artery embolization(Group A).A total of 25 other pregnant women in their mid-or third-trimester underwent cesarean section (Group B). Results 15 subjects out of 18 fetus were delivered by themselves, one of them coupled with severe uterine infection, one of them underwent laparoscopic hysterectomy because of placenta implantation, while 3 subjects out of 18 underwent cesarean section because of massive vaginal bleeding. The average amount of vaginal bleeding of Group B was 780ml, 5 subjects out of 25 underwent laparoscopic hysterectomy. Conclusion Pre-operative uterine arterial embolization is a safe approach to prevent or reduce potential intra-operative bleeding in the induction of labor for pregnant women in their mid- or third-trimester with complete placenta previa, but it is important to rule out placenta implantation with type-B ultrasoniccheck and MRI.