Original Article

Conservative Management of Placenta Increta: Case Report and Literature Review

Abstract

Placenta increta, a rare complication of pregnancy, is associated with significant postpartum hemorrhage often requiring emergency hysterectomy. We report a case of conservative management, with a combination of parenteral methotrexate, serial ultrasound and β-hCG assessment. Serum β-hCG levels were undetectable after 8 weeks of therapy. A scan at 6 months showed complete involution of the uterus. Review of the literature discussing the diagnostic tools, clinical features, management and outcome of pregnancies with placenta increta.

Breen JL, Neubecker R, Gregori CA, Franklin JE Jr. Placenta accreta, increta, and percreta. A survey of 40 cases. Obstet Gynecol 1977;49(1):43-7.

Harer WB. Placenta accreta; report of eight cases. Am J Obstet Gynecol 1956;72(6):1309-14.

Lam H, Pun TC, Lam PW. Successful conservative management of placenta previa accreta during cesarean section. Int J Gynaecol Obstet 2004;86(1):31-2.

Mussalli GM, Shah J, Berck DJ, Elimian A, Tejani N, Manning FA. Placenta accreta and methotrexate therapy: three case reports. J Perinatol 2000;20(5):331-4.

Miller DA, Chollet JA, Goodwin TM. Clinical risk factors for placenta previa-placenta accreta. Am J Obstet Gynecol 1997;177(1):210-4.

ACOG committee opinion. Placenta accreta. Number 266, January 2002. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 2002;77(1):77-8.

Thorp JM Jr, Councell RB, Sandridge DA, Wiest HH. Antepartum diagnosis of placenta previa percreta by magnetic resonance imaging. Obstet Gynecol 1992;80(3 Pt 2):506-8.

Read JA, Cotton DB, Miller FC. Placenta accreta: changing clinical aspects and outcome. Obstet Gynecol 1980;56(1):31-4.

Arulkumaran S, Ng CS, Ingemarsson I, Ratnam SS. Medical treatment of placenta accreta with methotrexate. Acta Obstet Gynecol Scand 1986;65(3):285-6.

Timmermans S, van Hof AC, Duvekot JJ. Conservative management of abnormally invasive placentation. Obstet Gynecol Surv 2007;62(8):529-39.

Files
IssueVol 49, No 6 (2011) QRcode
SectionOriginal Article(s)
Keywords
Placenta increta Conservative Management Methotrexate

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Yarandi F, Eftekhar Z, Shojaei H, Rahimi-Sharbaf F, Baradaran F. Conservative Management of Placenta Increta: Case Report and Literature Review. Acta Med Iran. 1;49(6):396-398.