臨床婦人科産科77巻5号

2023年05月発行

今月の臨床 産科救急―意識障害と危機的出血の初期対応

後期分娩後異常出血への対応

RPOCの画像診断と治療―胎盤遺残・ポリープ

著者： 田中利隆¹

所属機関： ¹順天堂大学医学部附属静岡病院産婦人科

ページ範囲：P.514 - P.523

文献概要

●後期分娩後異常出血の原因としてretained products of conception（RPOC）を常に念頭に置き，診断のための超音波検査ではBモードに加えてカラードプラ法を必ず併用する．

●RPOCの治療法として，保存的療法と侵襲的療法（D&C，TCR，UAEなど）が選択肢となるが，それぞれの症例のリスクなど評価したうえで治療法を決定する．

●その時点で正確な診断が困難だったとしても，血流豊富な子宮腔内の病変に対して安易に子宮内容除去術を行うことは避ける．

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