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Conservative Management of Placenta Percreta: Experiences in Two Cases

Hays, Amaryllis M. E. MD; Worley, Kevin C. MD; Roberts, Scott R. MD

doi: 10.1097/AOG.0b013e3181794727
Case Reports
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BACKGROUND: The management of an abnormally invaded placenta presents a challenging obstetric problem. Recent reports have suggested that a conservative approach to the treatment of this condition is appropriate in selected cases. We present the courses of two women with suspected placenta percreta who were managed conservatively and the complications that ensued.

CASES: Two multiparous women underwent elective repeat cesarean deliveries and were found to have clinical evidence of placenta percreta with bladder invasion. In both cases, the placenta was left in situ and medical management was attempted with methotrexate. Both women developed significant delayed complications requiring reoperation and hysterectomy, and both required multiple transfusions.

CONCLUSION: Conservative management of the abnormally invaded placenta should be undertaken with caution, and complications should be anticipated.

Conservative management of the abnormally invaded placenta should be undertaken with caution, and complications should be anticipated.

From the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas.

See related editorial on page 417.

Corresponding author: Kevin C. Worley, MD, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard., Dallas, Texas 75390-9032; e-mail: kworle@parknet.pmh.org.

Financial Disclosure The authors have no potential conflicts of interest to disclose.

© 2008 The American College of Obstetricians and Gynecologists