ABSTRACT
BACKGROUND: We present a case involving conservative treatment of placenta accreta, with a subsequent diagnosis of Asherman's syndrome. CASE PRESENTATION: A 41-year-old Japanese woman (G2P0A2) delivered a healthy male infant via cesarean section due to preeclampsia. The placenta did not spontaneously separate and was manually removed. Adhesion was tight and placenta accreta was diagnosed. During the procedure, no uterine inversion or perforation, and no uterine cavity adhesion, were observed. Four months postoperatively, hysteroscopy was performed. Adhesion was detected at the fundus of her uterus where the placenta had adhered to the uterus. Asherman's syndrome was diagnosed. CONCLUSIONS: Asherman's syndrome might occur after conservative management of placenta accreta, which may be a direct cause of placenta accreta recurrence. When Asherman's syndrome is diagnosed, the site of the placenta and adhesion should be monitored during subsequent pregnancies.
Subject(s)
Cesarean Section/adverse effects , Conservative Treatment , Gynatresia/diagnosis , Placenta Accreta/therapy , Tissue Adhesions/pathology , Uterus/pathology , Adult , Female , Gynatresia/pathology , Gynatresia/therapy , Humans , Hysteroscopy , Placenta Accreta/diagnostic imaging , Placenta Accreta/pathology , Pregnancy , Prognosis , Tissue Adhesions/complications , Tissue Adhesions/diagnostic imaging , Treatment OutcomeSubject(s)
Abortion, Spontaneous , Uterine Rupture , Cervix Uteri , Delivery, Obstetric , Female , Fetal Membranes, Premature Rupture , Humans , PregnancyABSTRACT
We report a case of sudden-onset disseminated intravascular coagulation during cesarean delivery for a patient with a subserosal leiomyoma. Rupture of hidden anastomotic vessels resulted in a significant decrease in fibrinogen levels and uncontrolled bleeding. Uterine venous flow disturbance caused by subserosal leiomyoma compression can possibly cause such a situation.
ABSTRACT
Eculizumab in pregnancy has been reported to be effective in improving outcomes in patients with paroxysmal nocturnal hemoglobinuria. However, a cesarean section may result in surgery-triggered hemolysis. An additional dose of eculizumab just prior to delivery is an appropriate choice to prevent postoperative hemolysis.
ABSTRACT
UNLABELLED: In order to know the comlement activation, the changes of compliment were evaluated in recurrent abortion and pregnancy loss patients with antiphospholipid antibody (APA) positive. Serum samples were taken from 82 patients with more than 2 recurrent abortion patients and/or pregnancy loss. Fifty eight cases of 82 patients were APA and antinuclear antibody negative without autoimmune disease. Anticardiolipin antibody (ACA), anti CL/beta2-GPI antibody (CL/beta2-GPI) were measured using ELISA. Lupus anticoagulant (LAC) was measured using diluted RVVT. CH50 and C3 and C4 were measured as complements. The number of positive cases of ACA, CL/beta2-GPI, LAC was 23, 9 and 5 cases, respectively. RESULTS: The levels (mean+/-SD) of CH50, C3 and C4 in ACA positive and negative cases were 38.8+/-8.3 U/ml, 82.7+/-20.1 mg/dl, 18.5+/-5.7 mg/dl and 42.4+/-6.9 U/ml, 93.5+/-17.6 mg/dl, 21.1+/-4.6 mg/dl, respectively. The levels of CH50, C3 and C4 in positive cases were significantly lower than negatives. The levels of CH50, C3 and C4 in CL/beta2-GPI and LAC positive cases were also significantly lower than negatives. CONCLUSION: The comlement activation was demonstrated in recurrent abortion and pregnancy loss with antiphospholipid antibody positive.
