Conservative Management of Retained Placenta Accreta Postpartum

Eun Hui Joo; Ji Eun Ko; Hee lim Lee; Hyeon Chul Kim; Young Ran Kim

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자료유형: 학술저널

저자정보: Eun Hui Joo (CHA Bundang Medical Center) Ji Eun Ko (CHA Bundang Medical Center) Hee lim Lee (CHA Bundang Medical Center) Hyeon Chul Kim (CHA Bundang Medical Center) Young Ran Kim (CHA Bundang Medical Center)

저널정보: 대한주산의학회 Perinatology Perinatology Vol.32 No.2

발행연도: 2021.1

수록면: 75 - 79 (5page)

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Retained placenta accreta is difficult to diagnose in the series of processes involved in parturition. It is usually discovered after delivery, when massive and uncontrollable postpartum hemorrhage occurs. A histological examination of residual placental tissue is the gold standard for the diagnosis of retained placenta accreta and indicates the degree of placental invasion into the myometrium. If the placenta is forcefully removed, maternal morbidity and mortality is high. Therefore, the management is essential when the placenta cannot be delivered spontaneously or manually. We present a case of a 35-year-old woman (G4P2A1L2) who had a high risk of placenta accreta due to past history of placenta accreta and previous myomectomy. After successful delivery, the placenta was not delivered as expected. Consequently, she experienced massive post-partum hemorrhage of 1,500 mL for up to 2 days post-partum, necessary of an extensive blood transfusion. Following spontaneous vaginal delivery and a failed attempt to manually remove the placenta, a uterine artery embolization was performed, and the patient improved over a few weeks. Thus, this case was successfully managed with conservative treatment, avoiding hysterectomy or other additional surgical treatments. No secondary postpartum complications were observed, and the menstrual cycle returned to normal within 6 months.

#Placenta accrete #Postpartum hemorrhage #Conservative treatment #Uterine artery embolization #Maternal mortality

참고문헌 (16)

참고문헌 신청

Zhong L / 2017 / Management of patients with placenta accreta in association with fever following vaginal delivery / Medicine (Baltimore) 96:e6279

Wortman AC / 2013 / Placenta accreta, increta, and percreta / Obstet Gynecol Clin North Am 40:137~154

Kreinin A / 2018 / Methotrexate treatment for retained placental tissue after second trimester termination of pregnancy / Isr Med Assoc J 20:388~390

Peng ZH / 2019 / Prophylactic abdominal aortic balloon occlusion : an effective method of controlling hemorrhage in patients with placenta previa or accreta / Exp Ther Med 17:1492~1496

Alonso L / 2018 / Hysteroscopic removal of retained products of conception implanted over a focal area of adenomyosis : a case report / J Minim Invasive Gynecol 25:382~383

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