Conservative management of placenta percreta: experiences in two cases.
BACKGROUND
The management of an abnormally invaded placenta presents a challenging obstetric problem. Recent reports have suggested that a conservative approach to the treatment of this condition is appropriate in selected cases. We present the courses of two women with suspected placenta percreta who were managed conservatively and the complications that ensued.


METHODS
Two multiparous women underwent elective repeat cesarean deliveries and were found to have clinical evidence of placenta percreta with bladder invasion. In both cases, the placenta was left in situ and medical management was attempted with methotrexate. Both women developed significant delayed complications requiring reoperation and hysterectomy, and both required multiple transfusions.


CONCLUSIONS
Conservative management of the abnormally invaded placenta should be undertaken with caution, and complications should be anticipated.
Hays
Amaryllis M E
AM
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9032, USA.
Worley
Kevin C
KC
Roberts
Scott R
SR
D005260:Female; D006801:Humans; D007044:Hysterectomy; D008727:Methotrexate / Q000627:therapeutic use; D019384:Nucleic Acid Synthesis Inhibitors / Q000627:therapeutic use; D010921:Placenta Accreta / Q000628:therapy*; D011247:Pregnancy; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000628:therapy
D019384:Nucleic Acid Synthesis Inhibitors; D008727:Methotrexate