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Опыт органосохраняющего лечения артериовенозной мальформации матки при врастании плаценты

Опыт органосохраняющего лечения артериовенозной мальформации матки при врастании плаценты

Abstract

Артериовенозная мальформация матки (АВМ) является редким, но потенциально опасным для жизни пациенток состоянием. АВМ, часто клинически проявляющаяся аномальным маточным кровотечением, ассоциирована с беременностью и травмой матки. Цель исследования — описание клинического случая артериовенозной мальформации матки при врастании плаценты. Материал и методы. Пациентка с аномальным маточным кровотечением в течение 6 мес, начавшимся через 2 мес после родов, на фоне регулярного кормления грудью. Результаты и их обсуждение. С целью диагностики проводилось трансвагинальное УЗИ в серой шкале, цветное и спектральное допплеровское картирование, определение р-субъединицы хорионического гонадотропина человека (ХГЧ) в сыворотке крови в динамике; общеклинические исследования, МРТ. Лечение включало 2 этапа: гистерорезекцию плацентарной ткани и эмболизацию маточных артерий. Заключение. Органосохраняющее лечение позволило не только сохранить матку, но и менструальную функцию, что позволяет надеяться на сохранение фертильности.

Uterine arteriovenous malformation (AVM) is a rare but potentially life-threatening condition of patients. AVMs often present with abnormal uterine bleeding and commonly are seen in association with pregnancy and uterine trauma. Aim. The article presents a clinical case of arteriovenous malformation of the uterus in placenta increta. Material and methods. The patient with abnormal uterine bleeding for 6 months, beginning 2 months after birth. Results and discussion. The studies encompassed transvaginal ultrasound using gray-scale, color and spectral Doppler imaging, the identification of p-subunit of human chorionic gonadotropin (P-HCG) in blood serum in the dynamics; clinical examinations, MRI. The treatment included 2 stages: hysteroresection placental tissue and uterine artery embolization. Conclusion. Sparing treatment has allowed not only to preserve the uterus, and menstrual function that allows to hope for preservation of fertility.

Keywords

артериовенозная мальформация матки, трансвагинальное ультразвуковое исследование (2DTVS), допплерометрия, цветное допплеровское картирование (ЦДК), гистерорезекция, эмболизация маточных артерий.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
gold