Abstract
IntroductionPlacenta percreta is an obstetric emergency often associated with massive hemorrhage and emergency hysterectomy.Case presentationWe 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.ConclusionsFurther 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.
Highlights
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
Maternal morbidity and mortality associated with Placenta accreta (PA) is mainly caused by massive obstetric hemorrhage or emergency hysterectomy, and PA is often diagnosed during delivery or immediately postpartum leading to an obstetric emergency [1,3,4]
We describe a severe case of PA histopathologically defined as placenta percreta in which the placenta was left in situ
Summary
Placenta accreta (PA) is characterized by abnormal invasion of the placenta into the myometrium. Case presentation Our patient was a 30-year-old African woman, gravida 7, para 5 Her second screening ultrasound at 21 weeks of gestation showed normal fetal anatomy and placenta previa. Our patient received a single 100 mg dose of intra-muscular methotrexate She recovered uneventfully with no complications, and was discharged on the seventh day postpartum. A pelvic examination showed no significant findings She again returned to the emergency room a week later because of recurrent low abdominal pain. Our patient again returned to the emergency room three weeks later (seven weeks from the Caesarean section) because of heavy uterine bleeding. Her general condition was satisfactory, and she received three units of red blood cells and was hospitalized at this time. She was discharged on the fifth post-operative day in good condition
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