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. 2012 Nov;72(11):1033-1035.
doi: 10.1055/s-0032-1327941.

Bilateral Renal Cortical Necrosis with Chronic Renal Failure as a Result of Placenta Percreta in a Twin Pregnancy - A Case Report

A Biener  1 , N Klünder  1
Affiliations

Bilateral Renal Cortical Necrosis with Chronic Renal Failure as a Result of Placenta Percreta in a Twin Pregnancy - A Case Report

A Biener et al. Geburtshilfe Frauenheilkd. 2012 Nov.

Abstract
in English, German

A 22-year-old gravida II, para I, with a twin pregnancy was diagnosed with placenta praevia totalis et percreta in 25 GW. After consideration of various modes of delivery a C-section was performed with retention of the placenta percreta in situ when vaginal bleeding occured in 28 GW. Following 8 dosages of methotrexate given on an outpatient basis, the patient suddenly developed acute renal failure necessitating dialysis. This was due to a bilateral renal cortical necrosis after disseminated intravasal coagulation based on a massive accumulation of trophoblastic tissue.

Bei einer 22-jährigen II.-Gravida, I.-Para mit Geminigravidität wurde in der 25. SSW eine Placenta praevia totalis et percreta diagnostiziert. Nach Abwägung verschiedener Entbindungsmodi wurde bei vaginaler Blutung in der 28. SSW eine Sectio mit Belassen beider Zwillingsplazenten in situ durchgeführt. Im Anschluss an 8 ambulante Zyklen Methotrexat i. m. entwickelte die Patientin plötzlich eine Niereninsuffizienz mit Dialysepflichtigkeit. Diese kam durch eine bilaterale Nierenrindennekrose in Folge einer ausgeprägten disseminierten intravasalen Gerinnung aufgrund einer massiven Trophoblasteinschwemmung zustande.

Keywords: placenta percreta; placenta praevia; renal failure; twin pregnancy.

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Conflict of interest statement

Conflict of Interest None.

Figures

Fig. 1
Fig. 1
Sonographic imaging of placenta praevia totalis et percreta in our patient.
See this image and copyright information in PMC

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