title: Uterine conservation despite severe sepsis in a case of placenta accreta first treated conservatively: 3-month delayed successful removal of the placenta.
abstract: OBJECTIVE
  To report a case of successful delayed removal of a placenta accreta first treated conservatively. Secondary infectious complications can occur after conservative management in cases of placenta accreta, most often leading to hysterectomy.
  
  
  METHODS
  Case report.
  
  
  METHODS
  A French teaching hospital.
  
  
  METHODS
  A 33-year-old woman.
  
  
  METHODS
  A healthy 33-year-old woman underwent Cesarean section for her first pregnancy. Diagnosis of placenta accreta was made at ultrasound scanning for her second pregnancy. She was first treated conservatively. Hysterectomy was planned 3 months after conservative treatment because of sepsis attributed to uterine retention. (Hysterotomy was first realized.)-??
  
  
  METHODS
  Uterine conservation.
  
  
  RESULTS
  The placenta was easily and successfully removed with no subsequent bleeding. The uterus was sutured and conserved.
  
  
  CONCLUSIONS
  In cases of delayed sepsis because of uterine retention after conservative treatment for placenta accreta, when medical treatment remains unsuccessful, manual removal of the placenta should be attempted. This approach might allow improved uterine conservation rates in women with placenta accreta treated conservatively.
authors.affiliation: Obstetrics and Gynecology unit, Lariboisière Hospital, APHP, Paris, France. olivier.morel17@wanadoo.fr
authors.forename: Olivier
authors.initials: O
authors.lastname: Morel
authors.forename: Patrice
authors.initials: P
authors.lastname: Desfeux
authors.forename: Yann
authors.initials: Y
authors.lastname: Fargeaudou
authors.forename: Cécile
authors.initials: C
authors.lastname: Malartic
authors.forename: Mathias
authors.initials: M
authors.lastname: Rossignol
authors.forename: Chantal
authors.initials: C
authors.lastname: Perrotez
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Barranger
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010921:Placenta Accreta / Q000473:pathology / Q000601:surgery*; D011247:Pregnancy; D018805:Sepsis / Q000209:etiology*; D013997:Time Factors