Hysteroscopic Resection for Placental Polyp With Temporary Laparoscopic Uterine Artery Clipping

宫腔镜下胎盘息肉切除术联合临时性腹腔镜下子宫动脉夹闭术

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Abstract

Placental polyps, consisting of residual trophoblastic tissue after delivery or miscarriage, are also known as a type of retained products of conception (RPOC). This is a rare but potentially severe condition that can cause significant hemorrhage, which can be life-threatening. Uterine artery embolization (UAE) followed by hysteroscopic transcervical resection (TCR) is used as a uterine-preserving intervention. However, the UAE may not be ideal for patients seeking a future pregnancy because of the potential risks of uterine ischemia and infection. Herein, we report a case of a 38-year-old woman with a placental polyp and hemorrhagic shock that developed after a miscarriage. Following the transfusions of eight units of red blood cells and four units of fresh frozen plasma, the patient recovered. Transvaginal ultrasonography revealed a hypervascular mass in the uterine cavity, suggestive of a placental polyp. We performed temporary laparoscopic uterine artery clipping to minimize bleeding, followed by TCR. This procedure may be an effective alternative to UAE for preventing long-term uterine ischemia and preserving fertility.

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