title: Successful uterus-preserving surgery for treatment of chemotherapy-resistant placenta increta.
abstract: Treatment of placenta increta often entails abdominal total hysterectomy. We present a case of placenta increta in which 3-dimensional computed tomography shows very high blood flow to the placenta, even after chemotherapy with methotrexate. Nonetheless, we were able to remove the region of the uterus that had been invaded by chorionic villi. Massive bleeding during the operation was prevented by ligation of the hypogastric artery and local injection of vasopressin. The combination of chemotherapy and partial resection of the uterus is quite a unique treatment for placenta increta patients. This approach enabled preservation of the uterus and the patient's fertility. We suggest this procedure could be one of the treatments for patients who have placenta increta and wish to retain their fertility.
authors: Department of Obstetrics and Gynecology, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo, Japan. endot @ sapmed.ac.jp
authors: Toshiaki
authors: T
authors: Endo
authors: Takuhiro
authors: T
authors: Hayashi
authors: Ayumi
authors: A
authors: Shimizu
authors: Motoki
authors: M
authors: Matsuura
authors: Masahito
authors: M
authors: Mizuuchi
authors: Kunihiko
authors: K
authors: Nagasawa
authors: Yoshiaki
authors: Y
authors: Ezaka
authors: Tuyoshi
authors: T
authors: Baba
authors: Shinichi
authors: S
authors: Ishioka
authors: Tsuyoshi
authors: T
authors: Saito
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D004351:Drug Resistance; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008727:Methotrexate / Q000627:therapeutic use*; D010921:Placenta Accreta / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D011247:Pregnancy; D014057:Tomography, X-Ray Computed; D014599:Uterus / Q000601:surgery*
chemical_list: D008727:Methotrexate