title: Placenta accreta: conservative approach.
abstract: Placenta accreta refers to any abnormally invasive placental implantation. Diagnosis is suspected postpartum with failed delivery of a retained placenta. Massive obstetrical hemorrhage is a known complication, often requiring peripartum hysterectomy. The authors report a case of placenta accreta in a primiparous patient with multinodular leiofibromyomatosis of the uterus following failed manual removals of a retained placenta. They describe a conservative management in a stable patient desiring future fertility with a unilateral prophylactic uterine artery embolization, a multidose regimen of methotrexate, and a subsequent abdominal myomectomy.
authors.affiliation: Department of Obstetrics and Gynecology, University of L 'Aquila, Italy. giandiluigi@hotmail.com
authors.forename: G
authors.initials: G
authors.lastname: Di Luigi
authors.affiliation: Department of Obstetrics and Gynecology, University of L 'Aquila, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Patacchiola
authors.affiliation: Department of Obstetrics and Gynecology, University of L 'Aquila, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Di Stefano
authors.affiliation: Department of Obstetrics and Gynecology, University of L 'Aquila, Italy.
authors.forename: A
authors.initials: A
authors.lastname: D'Alfonso
authors.affiliation: Faculty of Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Carta
authors.affiliation: Department of Obstetrics and Gynecology, University of L 'Aquila, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Carta
mesh_terms: D004621:Embolization, Therapeutic; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D006801:Humans; D007044:Hysterectomy; D008727:Methotrexate / Q000008:administration & dosage; D010298:Parity; D010921:Placenta Accreta / Q000628:therapy*; D011247:Pregnancy; D055988:Uterine Artery; D063186:Uterine Myomectomy
chemical_list: D008727:Methotrexate