We present our own experience management in pregnant women with placenta percreta. For the timely diagnosis of placenta accreta or placenta percreta, it is recommended to conduct ultrasound and Magnetic Resonance Imag...We present our own experience management in pregnant women with placenta percreta. For the timely diagnosis of placenta accreta or placenta percreta, it is recommended to conduct ultrasound and Magnetic Resonance Imaging (MRI) studies in women with placenta previa and a history of caesarean section. Objective signs of placenta accreta, identified before delivery, make it possible to make the right decision about delivery and minimize complications in the mother and newborn. A coordinated interdisciplinary approach to these complex cases and early resuscitation with blood products are critical factors in the successful management of patients affected by this disease.展开更多
<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Spontaneous or traumatic rupture of spleen in pregna...<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Spontaneous or traumatic rupture of spleen in pregnancy is a rare event with catastrophic consequences. This report presents a case of spontaneous splenic rupture of a pregnant woman with thrombophilia in complicated somatic history and successful cesarean section with maternal and infant survival. </span><b><span style="font-family:Verdana;">Case:</span></b><span style="font-family:Verdana;"> A 28-year-old Armenian woman at 35 weeks of gestation presented to the Emergency Department at “Erebouni” medical center in Yerevan, Armenia with sharp pain in the epigastric region, general weakness and worsening condition. The patient was immediately transferred to the operating room. All clinical-laboratory examinations were urgently carried out, the fetus condition began to be assessed under the control of the CT. She was in obvious distress with blood pressure of 90/50 mm Hg and a pulse rate of 80 - 70 beats per minute. Abdominal ultrasound confirmed free fluid in the peritoneal cavity. Cesarean section was performed on the lower segment of the uterus. A live premature female infant was born weighing 2580 g, height 48 cm, and with an Apgar score of 7 - 8 points. Then the integrity of the uterus was restored. Abdominal rehabilitation was performed, there were about 1000 ml of blood loss and continuous internal bleeding. Doctors found splenic ruptures around the perineum. Lower middle laparotomy, splenectomy, abdominal rehabilitation, drainage were performed. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> This case illustrates the need to consider ruptured spleen as part of differential diagnosis of hemoperitoneum in pregnant women. Immediate surgical intervention is needed to ensure survival of mother and fetus.</span></span></span></span>展开更多
文摘We present our own experience management in pregnant women with placenta percreta. For the timely diagnosis of placenta accreta or placenta percreta, it is recommended to conduct ultrasound and Magnetic Resonance Imaging (MRI) studies in women with placenta previa and a history of caesarean section. Objective signs of placenta accreta, identified before delivery, make it possible to make the right decision about delivery and minimize complications in the mother and newborn. A coordinated interdisciplinary approach to these complex cases and early resuscitation with blood products are critical factors in the successful management of patients affected by this disease.
文摘<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Spontaneous or traumatic rupture of spleen in pregnancy is a rare event with catastrophic consequences. This report presents a case of spontaneous splenic rupture of a pregnant woman with thrombophilia in complicated somatic history and successful cesarean section with maternal and infant survival. </span><b><span style="font-family:Verdana;">Case:</span></b><span style="font-family:Verdana;"> A 28-year-old Armenian woman at 35 weeks of gestation presented to the Emergency Department at “Erebouni” medical center in Yerevan, Armenia with sharp pain in the epigastric region, general weakness and worsening condition. The patient was immediately transferred to the operating room. All clinical-laboratory examinations were urgently carried out, the fetus condition began to be assessed under the control of the CT. She was in obvious distress with blood pressure of 90/50 mm Hg and a pulse rate of 80 - 70 beats per minute. Abdominal ultrasound confirmed free fluid in the peritoneal cavity. Cesarean section was performed on the lower segment of the uterus. A live premature female infant was born weighing 2580 g, height 48 cm, and with an Apgar score of 7 - 8 points. Then the integrity of the uterus was restored. Abdominal rehabilitation was performed, there were about 1000 ml of blood loss and continuous internal bleeding. Doctors found splenic ruptures around the perineum. Lower middle laparotomy, splenectomy, abdominal rehabilitation, drainage were performed. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> This case illustrates the need to consider ruptured spleen as part of differential diagnosis of hemoperitoneum in pregnant women. Immediate surgical intervention is needed to ensure survival of mother and fetus.</span></span></span></span>
