Abstract:
BACKGROUND:Placenta percreta is a rare obstetric condition associated with the risk of massive intraoperative hemorrhage. Recently, conservative management of placenta percreta has been performed to reduce maternal morbidity. However, various complications have been reported during such management. Only a few cases of asymptomatic disseminated intravascular coagulation (DIC) or fever without infection have been reported. Here, we discuss such a case and review the related literature to understand this rare condition better. For this, we performed an electronic literature review. CASE PRESENTATION:We present the clinical course, results of blood tests, and serial magnetic resonance images of a 35-year-old female (gravida 5, para 2) with placenta percreta complicated by placenta previa that was managed conservatively. The patient successfully delivered a healthy baby by a cesarean delivery via a transverse uterine fundal incision at 36 weeks of gestation. We did not observe intraoperative complications during cesarean delivery, and the postoperative course remained uncomplicated until 47 days after the delivery. However, asymptomatic DIC developed after 47 days, and her serum fibrinogen level declined to 42 mg/dL, which was successfully treated with anticoagulant therapy by a therapeutic dose of intravenous heparin for 22 days (postoperative days 48-69). Although DIC resolved, subsequent fever persisted for approximately 1 month (postoperative days 67-103). Infection was ruled out, and conservative management was successfully continued. Literature review revealed that successful conservative management of a patient with asymptomatic DIC and subsequent fever without infection is extremely rare. CONCLUSIONS:Some patients with DIC and fever can continue conservative management of placenta percreta, although careful examination and monitoring are needed.
journal_name
BMC Pregnancy Childbirthjournal_title
BMC pregnancy and childbirthauthors
Matsuzaki S,Yoshino K,Endo M,Tomimatsu T,Takiuchi T,Mimura K,Kumasawa K,Ueda Y,Kimura Tdoi
10.1186/s12884-017-1634-8subject
Has Abstractpub_date
2017-12-29 00:00:00pages
443issue
1issn
1471-2393pii
10.1186/s12884-017-1634-8journal_volume
17pub_type
杂志文章,评审abstract:BACKGROUND:Many studies have demonstrated the benefits of the addition of growth hormone (GH) to the controlled ovarian stimulation protocol in vitro fertilization (IVF) cycles in poor-respond patients, but the effect of GH on patients with poor embryonic development remain unclear. This paper was designed to investiga...
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