子宮鏡下手術により子宮を温存し得た胎盤ポリープの5症例の検討

抄録

Background: Placental polyps can causes massive postpartum hemorrhage. The traditional treatment for a placental polyp is a hysterectomy. However, for patients desirous of a subsequent pregnancy, an alternative treatment option is uterine artery embolization (UAE) and hysteroscopic surgery.
Patients: Case 1 is a 35-year-old Japanese gravida 0, para 0 who had an unremarkable medical and family history. She delivered at another hospital, and was transferred to our hospital because of massive hemorrhage secondary to residual placenta. The residual placenta was completely excised at our hospital. One month later, she was again transferred to our hospital due to recurrent hemorrhage; a placental polyp was imaged by an ultrasound examination. She was strongly desirous of uterine preservation; therefore, she was successfully treated by UAE and hysteroscopic resection of the placental polyp.
Cases 2 through 5 had similar clinical findings as that of Case 1 and were successfully treated by UAE and/or hysteroscopic surgery.
Conclusions: UAE and hysteroscopic surgery is effective for the treatment of a placental polyp. Conversely, some cases of placental polyps spontaneously resolve without any treatment. Therefore, we must recognize that there are many cases of placental polyps that can be treated with uterine preservation, if the general patient status is stable.