Articles

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.

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IssueVol 49, No 6 (2011) QRcode
SectionArticles
Keywords
Placenta increta Conservative Management Methotrexate

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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.