Successful conservative management of placenta percreta: Investigation by serial magnetic resonance imaging of the clinical course and a literature review.

Abstract

Placenta percreta is a rare condition that presents a risk of massive intraoperative hemorrhage. To decrease maternal morbidity in such cases, conservative management was recently adopted as an option. Nevertheless, severe morbidity occurs in 42% of cases. In addition, the clinical course of conservative management remains unclear. We encountered a case of placenta percreta that was successfully treated by conservative management without complications or other clinical interventions. Serial magnetic resonance imaging (MRI) was performed to investigate the natural course of conservative management of placenta percreta. MRI on postoperative day (POD) 99 showed a decrease in placental size without gadolinium enhancement. MRI on POD 162 showed that the residual placenta was approximately 4 cm in size without gadolinium enhancement. On POD 265, the placenta had almost disappeared. This is the first series of MRI of conservative management of placenta percreta without clinical interventions. We present our case and a literature review.

• Authors: Masaaki Sawada, Shinya Matsuzaki, Kazuya Mimura, Keiichi Kumasawa, Masayuki Endo, Tadashi Kimura
• Journal: The journal of obstetrics and gynaecology research (J Obstet Gynaecol Res) Vol. 42 Issue 12 Pg. 1858-1863 (Dec 2016) ISSN: 1447-0756 [Electronic] Australia
• PMID: 27527121 (Publication Type: Case Reports)
• Copyright: © 2016 Japan Society of Obstetrics and Gynecology.

Chemical References

• Contrast Media
• Gadolinium

Topics

• Adult
• Conservative Treatment
• Contrast Media
• Female
• Gadolinium
• Gestational Age
• Humans
• Magnetic Resonance Imaging
• Placenta Accreta (diagnostic imaging, surgery)
• Placenta Previa (surgery)
• Pregnancy
• Treatment Outcome
• Ultrasonography, Prenatal