An Unusual Presentation of Acute Subdural Hematoma Secondary to Disseminated Intravascular Coagulation Following Conservative Management of Placenta Increta

Muhammad Fairuz Abdul Rahman, Ghee Kheng Chew, Eng Loy Tan, Wei Ching Tan

Abstract


With increasing cesarean section rates around the world, there will be a corresponding rise in morbidly-adherent placenta cases, such as placenta increta. There have been no randomized controlled trials comparing different surgical treatment of placenta increta. Conservative management of placenta increta, though largely successful, can potentially lead to significant maternal morbidity, such as sepsis, hemorrhage, and mortality. We report a rare event of disseminated intravascular coagulation (DIVC) with spontaneous maternal subdural hematoma (SDH) arising from the conservative management of placenta increta. To our knowledge, there has been no such case reported in the literature. The patient was managed by a multidisciplinary team of gynecologists, anesthesiologists, neurosurgeons and hematologists when she presented with right-sided progressive headache and extensive bruising 9 weeks postpartum. Blood products were given to correct her hemodynamic status and she subsequently underwent an emergency hysterectomy, with resolution of the DIVC and her symptoms.




J Med Cases. 2018;9(1):34-36
doi: https://doi.org/10.14740/jmc2989w


Keywords


Acute subdural hematoma; Disseminated intravascular coagulation; Placenta increta

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