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Disseminated Intravascular Coagulation Complicating the Conservative Management of Placenta Percreta

Judy, Amy E. MD, MPH; Lyell, Deirdre J. MD; Druzin, Maurice L. MD; Dorigo, Oliver MD, PhD

doi: 10.1097/AOG.0000000000000960
Contents: Case Report

BACKGROUND: Retention of the placenta is an option in the management of placenta percreta; however, it may be associated with significant morbidity.

CASE: We present a case of conservative management of placenta percreta. Disseminated intravascular coagulation (DIC) developed 49 days after delivery. An urgent hysterectomy was performed, followed by rapid normalization of coagulation parameters.

CONCLUSION: Disseminated intravascular coagulation may complicate the conservative management of placenta percreta and can manifest weeks after delivery in the absence of antecedent hemorrhage or infection. The time course and presentation of this case are similar to the development of DIC after prolonged retention of a fetal demise with a probable shared pathophysiology. Close follow-up may facilitate prompt diagnosis of DIC, thereby minimizing associated morbidity.

Disseminated intravascular coagulation is a potential complication of the conservative management of placenta percreta.

Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California.

Corresponding author: Amy E. Judy, MD, MPH, 300 Pasteur Drive, Room HH333, Stanford, CA 94305; e-mail: ajudy@stanford.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2015 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.