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Re: new case. postpartum placenta accreta From: Bernard Cristalli (bcrist@club-internet.fr) Thu Jun 11 00:16:50 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Bernard Cristalli: "Re: breech and cerebral palsy" Previous message: Garry E. Siegel, M.D.: "OB: Isoimmunization and Retained POC" Maybe in reply to: ldf: "new case. postpartum placenta accreta" Next in thread: Malcolm Griffiths: "Re: new case. postpartum placenta accreta" ldf wrote: > > Please help me with this case. The patient is a G2 P2, vaginal delivery > 8 days ago, return to the hospital for heavy bleeding , needed 2 units > of blood transfusion. D&C done, retrieving placental tissue quite a bit. > Bleeding the stop. Today the ultrasound scan detect tissues infiltrating > the uterine wall and the uterus is again at the level of the umbilicus. > Placenta accreta is suspected. She is not bleeding at the moment. > She is on ergotinics and antibiotics. > What to do : expectant > if bleeding resume > hysterectomy > is there a place for methrotexate ? -- Metho is an option, but Nalador can be tried. More effective than pitocin or methergin. If it is not enough invasive techniques such as embolization, artery ligation and uterine wall padding may avoid hysterectomy. Depends on clinical state, local availabilities and woman's wishes. -- Bernard Cristalli MD CNGOF AIHP - ACCA Paris - France http://www.obgyn.net/corresp/cristalli.htm Next message: Bernard Cristalli: "Re: breech and cerebral palsy" Previous message: Garry E. Siegel, M.D.: "OB: Isoimmunization and Retained POC" Maybe in reply to: ldf: "new case. postpartum placenta accreta" Next in thread: Malcolm Griffiths: "Re: new case. postpartum placenta accreta"

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