Abstract
Fetal and/or placental mRNA in maternal plasma has been detected during pregnancy, and such mRNA tends to be stable against degradation (1). A quantitative study of plasma mRNA for γ-globin and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) showed significantly higher concentrations in pregnant women than in nonpregnant women (2). These findings suggest that the quantitative analysis of placental mRNA in maternal plasma may be a useful method to monitor placental status. In this study, we measured placental mRNA in maternal plasma to evaluate residual placenta in a pregnant woman with placenta previa-percreta (PPP) and bladder invasion that was diagnosed by both magnetic resonance imaging and pathology examination. Although a supravaginal hysterectomy just after the cesarean section (the first surgery) was done at 37 weeks of gestation, a 16-cm placental mass close to the internal os of the uterus could not be removed. Therapy with methotrexate (MTX) was therefore initiated on days 1–4, days 14–17, and days 33–36 after the first surgery (on day 0) to aid resorption of the placental residue, and a second surgery was performed to complete the hysterectomy …
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