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. 2011 Aug 25:5:418.
doi: 10.1186/1752-1947-5-418.

Placenta previa percreta left in situ - management by delayed hysterectomy: a case report

Minna Tikkanen  1 , Vedran Stefanovic, Jorma Paavonen
Affiliations

Placenta previa percreta left in situ - management by delayed hysterectomy: a case report

Minna Tikkanen et al. J Med Case Rep. .

Abstract

Introduction: Placenta percreta is an obstetric emergency often associated with massive hemorrhage and emergency hysterectomy.

Case presentation: We present the case of a 30-year-old African woman, gravida 7, para 5, with placenta percreta managed by an alternative approach: the placenta was left in situ, methotrexate was administered, and a delayed hysterectomy was successfully performed.

Conclusions: Further studies are needed to develop the most appropriate management option for the most severe cases of abnormal placentation. Delayed hysterectomy may be a reasonable strategy in the most severe cases.

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Figures

Figure 1
Figure 1
Ultrasonography findings at gestational week 29 consistent with placenta accreta.
Figure 2
Figure 2
Operative findings during Caesarean section. Note placenta previa associated with placenta accreta suggestive of placenta percreta.
Figure 3
Figure 3
Ultrasonographic findings of placenta accreta left in situ with measurements to estimate the total volume during follow-up.
Figure 4
Figure 4
Uterine findings during laparotomy. Note Caesarean section scar at uterine fundus and bulging isthmic part with placenta accreta/percreta.
Figure 5
Figure 5
Hysterectomy specimen opened. Note placenta previa percreta left in situ.
Figure 6
Figure 6
Histopathological specimen consistent with placenta percreta (magnification 40 ×).
See this image and copyright information in PMC

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