Management of puerperal inferior vena cava thrombosis after massive hemorrhage due to placenta increta

Background. The significance of a clinical case of life-threatening complications of true ingrowth of placenta previa, such as massive hemorrhage and inferior vena cava thrombosis with a high risk for pulmonary embolism, is determined by the geometric increase in the incidence of abnormally invasive placenta and by the association of near-miss cases with the latter, which dictates the systematization of practical knowledge, the evaluation of the effectiveness of various options for obstetric tactics, and the elaboration of an interdisciplinary approach. Clinical case report. In the absence of antenatal diagnosis of placental ingrowth, complications, such as hemorrhage and thrombosis of the inferior vena cava, cannot be prevented in obstetric facilities of different medical care levels during staged treatment. The provision of care to the patient by the physicians of an emergency and planned counseling team and a pediatric neonatology team of the regional perinatal center in the central district hospital, followed by specialized treatment determined a favorable outcome for both the mother and the newborn. A separate analysis of complicating factors occurring in the management of pregnant and puerperal women with vital complications of placental ingrowth updates the issues of early diagnosis, optimal delivery tactics, preoperative readiness of a multidisciplinary team, and timely prevention of thromboembolic events. Conclusion. The accumulation of clinical experience and the elaboration of high-evidence-based treatment policy will undoubtedly make it possible to avoid critical conditions and to substantiate an organ-sparing approach as a determining one.

placental ingrowth, hemorrhage, inferior vena cava thrombosis, prevention of thromboembolic events