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目的探讨足月宫角妊娠的临床表现、并发症及其临床处理,以提高对足月宫角妊娠的认识,进一步提高产科的救治水平。方法回顾性分析2012年1月至12月间北京市朝阳区妇儿医院诊治过的足月宫角妊娠共3例,结合文献探讨其诊治经过并总结经验。结果 3例患者均为剖宫产术中确诊,表现为产后子宫形态异常,一侧子宫角处肌层异常薄弱,局部不收缩,导致产后出血,甚至紧急子宫切除。结论足月宫角妊娠因宫腔形态异常,易出现胎位异常;因患侧宫角处肌层薄弱,易出现底蜕膜发育缺陷致胎盘植入及局部不收缩,导致产后出血,甚至威胁产妇生命。在临床工作中应提高对该类病理妊娠的认识与警惕,积极个体化应对足月宫角妊娠出现的并发症,保障母婴安全。
Objective To investigate the clinical manifestations, complications and clinical management of full-term pregnancy in order to improve the understanding of full-term pregnancy and further improve the treatment level of obstetrics. Methods A retrospective analysis of January to December 2012 in Chaoyang District, Beijing Women and Children Hospital diagnosis and treatment of foot full moon palace pregnancy a total of 3 cases, combined with the literature to discuss its diagnosis and treatment after and sum up experience. Results All the 3 patients were diagnosed by cesarean section. The abnormalities of the uterus in postpartum were found. The abnormal myometrium in the uterine horn on one side was weak and the local non-contractions resulted in postpartum hemorrhage and emergency hysterectomy. Conclusion Due to the abnormal uterine cavity pattern in the full-term pregnant women due to the abnormal uterine cavity, abnormal fetal position is easy to occur. Due to the weak myometrium in the ipsilateral horn of the affected side, placenta accreta defect and local non-contractile development may occur, leading to postpartum hemorrhage and even threatening maternal life . In clinical work should raise awareness and vigilance of such pathological pregnancy, and actively individualized response to complications of full-term palace angle pregnancy, to ensure the safety of mother and child.