Re: Placenta Increta

From: Arthur W. Curtis, Jr. (artcurtis@juno.com)
Sat Jun 21 14:47:56 1997


On Sat, 21 Jun 1997 08:41:05 -0500 ATFSOCCER@aol.com writes:

><< NOW---If the pack is sucessful in the short term (hematocrit is
> Advice? Countenance? Prayers? THANX!!!!! >>
>
>My anecdotal based suggestions would be to:
>
> 1. Stabilize , foley catheter, a 2nd IV 16 or 18 guage and 4u
> blood available.
> 2. Broad spectrum IV antibiotics 24-48 hrs.
> 3. Pull pack in 24 hrs.
> 4. If stable wait 24hr and discharge with methergine. Consider
> hysteroscopy with resectoscope in 6 weeks
> to remove any placental tissue??
> 5. For intractable bleeding I would consider consult with
> radiologist for uterine artery embolization.

Excellent. Would add:

6. Hemabate directely into fundus as pack is removed. 7. Serial HCG titers to follow residual placental tissue. 8. new shoes.

Art

~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Arthur Curtis, MD FACOG 100 Central Street Worcester, MA 01608 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~

>





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