Taiwanese Journal of Obstetrics and Gynecology
Volume 45, Issue 1 , Pages 64-66, March 2006

Septic Shock after Conservative Management for Placenta Accreta

  • Ying-Cheng Chiang
    • ,
  • Jin-Chung Shih

      Affiliations

    • Corresponding Author InformationCorrespondence to: Dr. Jin-Chung Shih, Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 10016, Taiwan
    • ,
  • Chien-Nan Lee

Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

Received 26 July 2005; received in revised form 1 August 2005; accepted 4 August 2005.

Article Outline

Summary 

Objective

The rate of placenta accreta has risen in the last three decades due to the increasing rate of cesarean section. Placenta accreta usually results in severe postpartum hemorrhage requiring massive blood transfusion and postpartum hysterectomy. Conservative treatment is an alternative in selected patients to preserve fertility and decrease postpartum hemorrhage, but the risks of conservative treatment have seldom been described.

Case Report

A 39-year-old woman with placenta accreta diagnosed during cesarean section was treated conservatively. Persistent puerperal fever with leukocytosis developed during the postpartum period in spite of long-term antibiotic treatment. Evacuation of the retained placenta resulted in septic shock, which occurred immediately after dilatation and curettage. An uneventful recovery was achieved after use of strong antibiotics and fluid challenge.

Conclusion

At present, there is no consensus about the optimal treatment for placenta accreta. Conservative treatment appears to be an alternative in selected patients, but the complications such as sepsis should be carefully identified and appropriately managed.

Key Words:  conservative treatment , placenta accreta , puerperal fever , septic shock

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PII: S1028-4559(09)60194-7

doi:10.1016/S1028-4559(09)60194-7

Taiwanese Journal of Obstetrics and Gynecology
Volume 45, Issue 1 , Pages 64-66, March 2006

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