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Uterine artery embolization for hemorrhage resulting from second-trimester abortion in women with scarred uterus: report of two cases

机译:子宫瘢痕妇女妊娠中期流产引起的子宫动脉栓塞术:两例报告

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摘要

This study was conducted to investigate the effect of uterine artery embolization for the treatment of hemorrhage following second-trimester labor induction for women with scarred uterus. Two cases of second-trimester abortion were retrospectively reviewed, both of which had a history of caesarean delivery and were complicated by gestational anemia. One was at 18 weeks’ gestation and presented with persistent vaginal bleeding for two months resulting in relatively large area of blood clot in uterine cavity. The other was at 25 weeks’ gestation with partial hydatidiform mole and presented with intermittent vaginal bleeding. Both patients presented with continuous and heavy vaginal bleeding after oral administration of mifepristone for labor induction, with one cervix left unopened, while the other cervix 3 cm left dilatation, yet felt obstructed by pregnant tissue. Both patients were immediately treated with uterine artery embolization (UAE). Both patients presented with alleviated hemorrhage and regular uterine contraction after UAE, followed by smooth induction of labor. No hemorrhage occurred since then during the follow-up. The results suggest that UAE is safe and effective for the treatment of massive hemorrhage of second-trimester abortion in women with scarred uterus. It can reduce time period of labor induction and alleviate hemorrhage, which not only rescues patients but also avoids cesarean sections and retains fertility for the pregnant.
机译:这项研究旨在探讨子宫动脉栓塞术在妊娠中期妊娠后子宫出血的妇女中治疗子宫出血的效果。回顾性分析了两个中孕流产病例,均具有剖腹产的历史,并伴有妊娠性贫血。其中一个在妊娠18周时出现,持续阴道出血两个月,导致子宫腔内血块面积相对较大。另一个是在妊娠25周时出现葡萄胎部分葡萄胎,并出现间歇性阴道出血。两名患者口服米非司酮引产后均出现连续大量阴道流血,其中一个子宫颈未张开,而另一个子宫颈左3 cm扩张,但仍被妊娠组织阻塞。两名患者均立即接受子宫动脉栓塞术(UAE)治疗。两名患者在阿联酋术后均出现出血减轻和子宫常规收缩,随后顺利引产。此后在随访期间未发生出血。结果表明,阿联酋安全有效地治疗子宫瘢痕scar妇女的妊娠中期大出血。它可以减少引产的时间并减轻出血,不仅可以挽救患者,而且可以避免剖宫产,并保留孕妇的生育能力。

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