Non- Surgical Approach in a Case of Placenta Accreta Complicated by a Pulmonary Embolus

Abstract

Placenta accreta, which is a serious complication of pregnancy that can be treated with a spectrum of treatment methods ranging from medical treatment to hysterectomy, is characterized by the abnormal adherence of the placental tissue to the uterine wall. The presence of a simultaneous pulmonary embolus necessitates more conservative treatment approaches due to anticoagulant treatment and limited lung capacity of the patient. In this case report, a case with these risk factors that was treated with alternative treatment methods rather than surgery is presented and these treatment options are discussed.

Keywords

• Placenta accreta, pulmonary embolism, methotrexate, uterine balloon tamponade

Non- Surgical Approach in a Case of Placenta Accreta Complicated by a Pulmonary Embolus

Abstract

Plasenta akreata, plasental dokunun uterin duvara anormal yapışması ile karakterize ve medikal tedaviden, histerektomiye kadar uzanan bir yelpazede tedavi edilebilen ciddi bir gebelik komplikasyonudur. Bu hastalıkla birlikte pulmoner embolinin olması ise hem antikoagülan tedavi hem de hastanın sınırlı akciğer kapasitesi nedeni ile daha konservatif tedavi seçeneklerine başvurmayı gerektirmektedir. Olgu sunumumuzda bu risk faktörlerine sahip bir hastada plasentası yerinde bırakılarak uygulanan cerrahi alternatifi yöntemler tartışılmıştır

Keywords

• Placenta accreta, pulmoner emboli, methotrexate, uterine balon tamponat

References

1. Oyelese Y, Smulian JC. Placenta previa, placenta accreta, and vasa previa. Obstet Gynecol 2006;107:927-41
2. Garmi G, Salim R. Epidemiology, etiology, diagnosis, and management of placenta accreta. Obstet Gynecol Int 2012; 2012: 873929
3. Middeldorp S. How I treat pregnancy-related venous thromboembolism. Blood 2011; 17; 118: 5394-400
4. Gronvall M, Tikkanen M, Tallberg E, Paavonen J, Stefanovic V. Use of Bakri balloon tamponade in the treatment of postpartum hemorrhage: A series of 50 cases from a ter- tiary teaching hospital. Acta Obstet Gynecol Scand 2013; 92: 433-8
5. Resnik R. Management of placenta accreta, increta, and percreta. AJOG practice Bultein Mar 22, 2013
6. Ferrazzani S, Guariglia L, Triunfo S, Caforio L, Caruso A. Conservative management of placenta previa-accreta by prophylactic uterine arteries ligation and uterine tam- ponade. Fetal Diagn Ther 2009; 25: 400-3
7. Ramoni A, Strobl EM, Tiechl J, Ritter M, Marth C. Conservative management of abnormally invasive placen- ta: four case reports. Acta Obstet Gynecol Scand 2013; 92: 468-71
8. Cengiz H, Yasar L, Ekin M, Kaya C, Karakas S. Management of intractable postpartum haemorrhage in a tertiary cen- ter: A 5-year experience. Niger Med J 2012; 53: 85-8

9. Georgiou C. Balloon tamponade in the management of post- partum haemorrhage: a review. BJOG 2009; 116: 748-57