Conservative treatment of placenta accreta.
Prolonged retained placenta causing a delayed postpartum hemorrhage is a relatively common occurrence. However, there is a dearth of medical literature describing fertility-preserving treatments when standard therapy fails. We present two cases in which protracted retained placenta due to placenta accreta was successfully treated by hysteroscopic resection. Two nulliparous women had spontaneous vaginal deliveries requiring manual placental extraction. Both experienced delayed postpartum hemorrhage and underwent suction curettage with ultrasound guidance. Both patients were found to have persistent products of conception with imaging consistent with placenta accreta. Both patients failed expectant management and subsequently underwent hysteroscopic resection with complete resolution of their symptoms. We conclude that hysteroscopic resection is a conservative therapeutic option for placenta accreta in stable patients.
Hatfield
Joanna L W
JL
Department of Obstetrics and Gynecology, University of Vermont College of Medicine, Burlington, Vermont, USA.
Brumsted
John R
JR
Cooper
Brian C
BC
D000328:Adult; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008279:Magnetic Resonance Imaging; D010920:Placenta / Q000473:pathology; D010921:Placenta Accreta / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006473:Postpartum Hemorrhage / Q000209:etiology*; D011247:Pregnancy; D014327:Trophoblasts; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging