Magnetic resonance imagining (MRI) and serial beta-human chorionic gonadotrophin (beta-hCG) follow up for placenta percreta.
BACKGROUND
Placenta percreta is a rare obstetric condition associated with life-threatening hemorrhage. MR imaging has a role in prenatal diagnosis of these cases. However, its role in the postnatal diagnosis and in the follow up yet to be established.


METHODS
A 33-year-old patient has adherent placenta following spontaneous delivery at 37 weeks gestation. MR imaging diagnosed placenta percreta. Intramuscular methotrexate treatment was initiated with follow up with serial beta-human chorionic gonadotrophin (beta-hCG). In spite of dropping of the level of beta-hCG, the trophoblastic tissue was still present 6 weeks postnatally where the patient complained of vaginal bleeding where she opted to abdominal hysterectomy.


CONCLUSIONS
Patients who are suitable for non-surgical therapy, T2-weighted MR imaging may, in conjunction with serial beta-hCG assays, provide an alternative treatment modality for cases of placenta percreta.
El-Bialy
Gehan
G
Department of Obstetrics and Gynaecology, Glan Clwyd Hospital, Denbighshire, UK.
Kassab
Ahmed
A
Armstrong
Magi
M
D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use; D000328:Adult; D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008727:Methotrexate / Q000627:therapeutic use; D010921:Placenta Accreta / Q000175:diagnosis* / Q000188:drug therapy; D049590:Postpartum Period / Q000097:blood; D011247:Pregnancy
D000020:Abortifacient Agents, Nonsteroidal; D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate