title: Conservative management of placenta percreta: experiences in two cases.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9032, USA.
authors.forename: Amaryllis M E
authors.initials: AM
authors.lastname: Hays
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Worley
authors.forename: Scott R
authors.initials: SR
authors.lastname: Roberts
mesh_terms: 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
chemical_list: D019384:Nucleic Acid Synthesis Inhibitors; D008727:Methotrexate