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Treatment of infected placenta accreta in the uterine horn by transabdominal temporary occlusion of internal iliac arteries: A case report and literature review

Journal

MEDICINE
Volume 102, Issue 32, Pages -

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MD.0000000000034525

Keywords

cornual pregnancy; internal iliac artery occlusion; placenta increta; retained placenta

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This case report describes the successful treatment of infected placenta accreta in the uterine horn using transabdominal temporary occlusion of internal iliac arteries. The diagnosis was made using 3-dimensional ultrasound and magnetic resonance imaging, and confirmed during surgery. After the temporary occlusion of both internal iliac arteries, the placenta was removed and the uterine defect repaired. The patient had a good postoperative recovery with normal body temperature, normal menstruation, and no complications observed.
Rationale:This case report aims to describe the treatment of infected placenta accreta in the uterine horn by transabdominal temporary occlusion of internal iliac arteries. Patient concerns:A 29-year-old female patient had a history of retained placenta for 28 days after labor induction in the second trimester of pregnancy because of fetal malformation. Diagnoses:Placenta accreta in the uterine horn was diagnosed by 3-dimensional ultrasound and magnetic resonance imaging, and the diagnosis was confirmed during the operation. Interventions:Laparotomy was performed to remove the placenta and repair the uterine defect after temporary occlusion of both internal iliac arteries. Outcomes:Body temperature and inflammatory markers were elevated at admission but returned to normal on the second day after surgery. Normal menstruation resumed approximately 1 month postoperatively. Ultrasound examination showed that the shape of the uterine cavity was normal. No postoperative complications were observed. Lessons:Temporary occlusion of the internal iliac artery can help effectively manage infected placenta accreta in the uterine horn.

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