title: Successful conservative management of placenta percreta: Investigation by serial magnetic resonance imaging of the clinical course and a literature review.
abstract: Placenta percreta is a rare condition that presents a risk of massive intraoperative hemorrhage. To decrease maternal morbidity in such cases, conservative management was recently adopted as an option. Nevertheless, severe morbidity occurs in 42% of cases. In addition, the clinical course of conservative management remains unclear. We encountered a case of placenta percreta that was successfully treated by conservative management without complications or other clinical interventions. Serial magnetic resonance imaging (MRI) was performed to investigate the natural course of conservative management of placenta percreta. MRI on postoperative day (POD) 99 showed a decrease in placental size without gadolinium enhancement. MRI on POD 162 showed that the residual placenta was approximately 4 cm in size without gadolinium enhancement. On POD 265, the placenta had almost disappeared. This is the first series of MRI of conservative management of placenta percreta without clinical interventions. We present our case and a literature review.
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Sawada
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Shinya
authors.identifier: http://orcid.org/0000-0001-5725-9994
authors.initials: S
authors.lastname: Matsuzaki
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Mimura
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kumasawa
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Endo
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000328:Adult; D000072700:Conservative Treatment; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D005865:Gestational Age; D006801:Humans; D008279:Magnetic Resonance Imaging; D010921:Placenta Accreta / Q000000981:diagnostic imaging* / Q000601:surgery*; D010923:Placenta Previa / Q000601:surgery; D011247:Pregnancy; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal
chemical_list: D003287:Contrast Media; D005682:Gadolinium
keywords: conservative management; magnetic resonance imaging; placenta percreta; placenta previa