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Successful conservative management of placenta percreta: Investigation by serial magnetic resonance imaging of the clinical course and a literature review
Author(s) -
Sawada Masaaki,
Matsuzaki Shinya,
Mimura Kazuya,
Kumasawa Keiichi,
Endo Masayuki,
Kimura Tadashi
Publication year - 2016
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13121
Subject(s) - placenta percreta , medicine , conservative management , magnetic resonance imaging , placenta , placenta accreta , obstetrics , radiology , pregnancy , surgery , fetus , genetics , biology
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.