A Case of Placenta Accreta Infection Managed by Hysterectomy After Treatment for Retained Products of Conception With Uterine Artery Embolization and Hysteroscopy

一例胎盘植入感染病例,经子宫动脉栓塞和宫腔镜治疗残留妊娠组织后行子宫切除术。

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Abstract

Retained products of conception (RPOC) are frequently associated with previous cesarean section (C-section), abortion, and intrauterine operations, which may affect subsequent pregnancies. A 38-year-old female had a history of C-section and two abortions. After the second abortion, she underwent evacuation of RPOC and was treated with uterine artery embolization (UAE) and hysteroscopic resection. She became pregnant again and vaginally delivered an infant at full term. After delivery, RPOC was suspected on magnetic resonance imaging (MRI), but the patient was discharged for follow-up. She was rehospitalized with a diagnosis of infection and a placental remnant. Antibiotics did not improve the infection; therefore, she underwent a total hysterectomy. After the operation, signs of infection rapidly improved. The pathological diagnosis was placenta accreta. This case was considered a high-risk group for RPOC. In such rare and complicated cases, it is important to consider the possibility of recurrent RPOC and provide sufficient explanations before delivery for subsequent intensive management.

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