子宫动脉栓塞术在中晚期妊娠前置胎盘出血引产中的应用

目的探讨子宫动脉栓塞术(UAE)在中晚期妊娠前置胎盘出血引产中的应用价值。方法采用Seldinger技术穿刺及导管超选择插管技术行双侧子宫动脉造影,并栓塞治疗16例中晚期妊娠前置胎盘患者,同时应用利凡诺羊膜腔注射引产治疗。结果中晚期妊娠子宫动脉明显增粗增长,分支明显增多增粗卷曲,与妊娠月龄成正比,胎盘血供丰富。15例术后平均4.5h胎儿及其附属组织娩出,无产后出血。1例孕26周中央型前置胎盘因引产失败(合并瘢痕子宫,有宫颈性难产史),栓塞术后6d行剖宫取胎术,术中出血约100ml。术后平均32.4d恢复月经。结论子宫动脉栓塞术在中晚期妊娠前置胎盘出血引产疗效可靠,保留生育功能,有促进引产的作用。

Clinical applicatiaon of uterine arterial embolization for treatment of placenta praevia with hemorrhage in advanced stage of pregnancy

Objective To investigate the value of the uterine arterial embolization for the placenta praevia and hemorrhage in late stage of pregnancy.Methods 16 patients of placenta praevia with hemorrhage in late stage of pregnancy were treated with uterine arterial embolization(UAE)and simultaneously with Lee Rivanol intra-amniotic membrane injection for artificial laboring.Results During late stage of pregnancy,uterine arteries appeared to be elongated and enlarged with numerous dilated tortuous branches with positive proportion to gestalional age,and rich in blood supply of the placenta.15 cases passed successfully through the induced abortion.The procedure completed with an average of 4.5 h afterwards,without postpartum hemorrhage.The other case failed due to complicated reasons and cured by caesarean section.Conclusion UAE is a safe and effective method for late stage placenta praevia with hemaorrhage and also provides the reservation of fertility and together with promotion of induced abortion.