Conservative management of abnormally invasive placenta: four case reports

Prenatal diagnosis of placenta increta and percreta is essential to avoid potentially life‐threatening hemorrhage by optimizing peripartal management. Invasive placentation presents significant challenges at cesarean section even for highly skilled surgeons. In the four cases of placenta increta/per...

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Bibliographic Details
Published in:Acta obstetricia et gynecologica Scandinavica 2013-04, Vol.92 (4), p.468-471
Main Authors: Ramoni, Angela, Strobl, Eva-Maria, Tiechl, Johanna, Ritter, Magdalena, Marth, Christian
Format: Article
Language:eng ; fre ; ger
Subjects:
Adult
Cesarean hysterectomy
Cesarean Section
Combined Modality Therapy
Embolization, Therapeutic - methods
Female
Humans
invasive placentation placenta increta
methotrexate
Methotrexate - therapeutic use
Placenta - abnormalities
Placenta - blood supply
Placenta - pathology
Placenta Accreta - therapy
placenta percreta
Postpartum Hemorrhage - prevention & control
Pregnancy
Treatment Outcome
Young Adult
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Summary:Prenatal diagnosis of placenta increta and percreta is essential to avoid potentially life‐threatening hemorrhage by optimizing peripartal management. Invasive placentation presents significant challenges at cesarean section even for highly skilled surgeons. In the four cases of placenta increta/percreta presented here we tried to avoid hysterectomy by leaving the placenta behind and tried to accelerate regression of placental tissue by administering methotrexate. The outcome in each of the four women was different, but no major bleeding occurred in any of the cases. Close follow‐up for many weeks is mandatory.
ISSN:0001-6349
1600-0412
DOI:10.1111/aogs.12079