Placental implantation of complications of postoperative complications after cesarean section

The 38 -year -old Li was pregnant for the first time 10 years ago and gave birth to a child. At that time, he thought that he had one anyway, and he had a matter of time without going through pain.After 10 years, I caught up with the two -child policy to let go of it, and Li was pregnant again, but this time it was not as smooth as the first time: this time:

When I was pregnant early, for the first time, I informed the fetal sac that was very close to the scar of the cesarean section. The local hospital suggested that she terminate her pregnancy because the fetal sac is dangerous if the fetal sac continues to the scar.

Li was unwilling to give up and ran several hospitals. Some doctors told her that if they were lucky, the fetal sac may also grow towards the uterus, so she chose to continue pregnancy.

By 30 weeks of pregnancy, the B -ultrasound examination is:

The placenta has passed through the uterine muscle layer, which is very close to the bladder, and the blood flow between the uterus and the bladder is rich:

The red and blue in the picture above represents blood flow.

The doctor at the local hospital told her that she was "placental implantation", because she was very dangerous and referred her to a large hospital.

Li had a cesarean section at 34 weeks of pregnancy.

The division of normal placenta and the muscle layer of the uterus is very clear, and the placental implantation is like this:

The placenta part is grown into the uterine muscle. According to the depth of the inside, it is divided into placenta adhesion, placental implantation and penetrating placenta implantation.

The placental adhesion is very shallow to invade the muscle layer;

The depth of invasion of the muscle layer is placental implantation;

Deeper is to penetrate the uterine muscles to the outermost layer of the uterus -the membrane layer, and even invades the organs next to the uterus. The most common is the bladder, which is the implantation of penetrating placenta.

Li, who mentioned earlier, has done a cesarean section. This is the high -risk factor of placental implantation, and the more number of cesarean sections, the greater the risk of occurrence;

In addition, the pre-placenta, the history of multiple abortion, the history of multiple abortion, the operation of the hysteroscopy, and the IVF-ET (IVF-ET) are also high-risk factor that causes placenta implantation.

After the baby comes out, the normal placenta will be peeling naturally, and the placenta that grows in the uterine muscles cannot be stripped by itself, which will cause more bleeding. In severe cases, it needs to remove the uterus and even endanger the life of pregnant mothers.

1. Choose hospitals with the ability to deal with this disease; (this is very important !!!)

2. Pre -delivery:

Actively treat anemia and maintain hemoglobin at normal level;

Do an ultrasonic at 3 to 4 weeks to evaluate the placenta position, the depth of the placental implantation and fetal development;

The experienced doctors formulate a childbirth plan, including the opportunity and method of childbirth (recommended for delivery at 34 ~ 36 weeks).

3. Damage:

Multiple disciplines such as obstetrics, gynecology, anesthesiology, pediatrics and other disciplines.

4. Treatment of placenta:

Hand placenta;

Placental reservation;

Remove the implanted placenta area;

"3-P" surgery: Remove the placental implantation and suture to reconstruct the normal uterine muscle layer around;

Remove the uterus.


Which method should be determined according to the specific circumstances.

The placental implantation is very dangerous, which is an important cause of severe postpartum bleeding, uterine resection, and death of pregnant women;

Once the diagnosis is confirmed, a hospital with experience should be selected, and multi -disciplinary participation will be participated in the treatment.

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