Journal of International Obstetrics and Gynecology ›› 2018, Vol. 45 ›› Issue (5): 563-567.

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Placenta Implantation Resected by Laparotomy Complicated by Fistulas: A Case Report and Literature Review

LIN Kai-xuan, YANG Lin-dong, HAO Qun,SHUI Ying-chun, WU Yuan-zhe   

  1. Department of Obstetrics and Gynecology, Nanjing General Hospital of Nanjing Military Region, Nanjing 210002, China
  • Received:2017-12-21 Revised:2018-09-09 Published:2018-10-15 Online:2018-10-18
  • Contact: WU Yuan-zhe,E-mail: wuzhe860103@sina.com E-mail:shiwudongqi@yahoo.cn

Abstract: Cesarean section is the most important risk factor while the incidence of placenta implantation appears to be increasing of late years. By comparison, uterine fistula is rare complication of uterus operation. A case transferred from the other hospital will be introduced in this article. The patient had her placental residue after her first vaginal delivery, which was followed by manual removal of placenta. Placenta implantation was proved by ultrasound and the placenta was bluntly resected by a laparotomy with the help of bilateral uterine arterial embolization. Postoperative lochia persisted and accompanied with abnormal taste, then uteroabdominal fistula occurred about 2 months later. We resected the fistula and remodeled the uterus after finishing the essory examination. The patient accepted sequential therapy of large dose of estrogen and progestogen to repair her endometrium. Three months later, the patient had her menstrual recurrence. Besides, this article reviews the high-risk factors, hazards, diagnosis and treatment of placental implantation, the application and complications of arteriovenous embolization, and the formation, diagnosis and treatment of uterine fistula. Our experience in treatment will be summarized at last.

Key words:  Placenta implantation, Placenta accreta, Embolization, therapeutic, Placenta left in situ, Fistula