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植入性胎盤於剖腹產中大量出血之急救處理:個案報告

Emergency Management of Placenta Accreta During a Cesarean Section with Massive Hemorrhage: A Case Report

摘要


婦女懷孕而為植入胎盤(placenta accerta)時,事先診斷不一定能夠确知。當其自然生產時,可能會導致產後大出血,休克而死亡;若選擇剖腹產時,亦可能因產科醫師經驗不足,或是麻醉醫師不及充份準備,也可能因流血過多輸血赶不及而死亡,不可不慎。今報告一例有前置胎盤(placenta previa)且為植入性胎盤之產婦進行剖腹產手術,出血量達9,500亳升,一度陷入出血性休克,最後決定施行子宮切除術,幸而康復的個案。

並列摘要


It is usually difficult to confirm a diagnosis of placenta accreta in a pregnant woman before delivery. During labor (with a natural birth or Cesarean section), postpartum hemorrhage may be encountered. If the obstetrician is not sufficiently experienced with placenta accreta patients or the anesthetic staff is not well prepared for a blood transfusion during the operation, the patient may die of hemorrhagic shock. Herein, we report a case of placenta accreta and previa during a cesarean section with massive blood loss of 9500 ml. A hysterectomy was finally performed and the patient was well postoperatively.

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