A case report on the treatment of total placenta increta after transvaginal delivery with integrated traditional Chinese and western medicine

Ann Palliat Med. 2022 Jan;11(1):384-393. doi: 10.21037/apm-21-3794.

Abstract

Placental increta can easily lead to secondary infections in the perinatal period. In severe cases, it can develop into sepsis and endanger the life of the mother. It is a difficult problem in obstetrics. The incidence of placenta increta is increasing due to the continuous increase of a number of related factors, such as cesarean section, uterine cavity surgery, and elderly pregnant women. Currently, various guidelines on the treatment of placenta increta focus recommend hysterectomy. However, with the adjustment of the fertility policy, more and more patients have a strong desire to retain the uterus, and the conservative treatment of placenta increta has become more common worldwide. We report a case study of a patient with a uterine cavity infection due to placenta increta. The report outlines the clinical manifestations, laboratory examinations, imaging examinations, pathological examinations, interventional therapy, and traditional Chinese medicine treatment. After vaginal delivery, the woman was diagnosed with placenta increta and uterine cavity infection. After active treatment, the implanted tissue could not be discharged normally, and the complicated infection could not be effectively controlled. After treatment with the Simiao Yongan decoction, the implanted tissue discharged totally. The infection index gradually decreased, the clinical manifestations returned to normal, and the prognosis was good. In this case, Chinese medicine effectively treated the uterine cavity infection caused by placenta increta after vaginal delivery. Thus, these results provide a new diagnosis and treatment choice for placental increta in clinical practice.

Keywords: Placenta increta; Si Miao Yongan Decoction; case report; infection.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cesarean Section
  • China
  • Female
  • Humans
  • Placenta
  • Placenta Accreta* / therapy
  • Placenta Previa*
  • Pregnancy