Methotrexate as Conservative Management for Morbidly Adherent Placenta (MAP): A Case Report

Abstract

Abnormal placental invasions continue to be a major problem in obstetrics and gynecology. It is a major cause of obstetric hemorrhage, with a high risk of mortality and morbidity. Morbidly Adherent Placenta (MAP) has become more common in recent years as a result of a variety of risk factors. Despite being highly sensitive and specific, routine pregnancy ultrasound can miss MAP diagnosis. As a result, other imaging modalities must be used in such doubtful cases. Furthermore, MAP is commonly treated with surgical interventions such as hysterectomy, which has a severe psychosocial impact on all child-bearing women-while using methotrexate for placenta in situ in MAP remains controversial to this day. Few studies have been conducted due to a lack of standard protocols. As a result, in our case, we propose an underutilized MAP conservative treatment called "methotrexate," which was successfully used in our patient to manage her adherent placenta with good outcomes and minimal side effects. We hope that by encouraging more research into the use of methotrexate for MAP, we can avoid hysterectomy and preserve fertility to the greatest extent possible.