Abstract | INTRODUCTION: CASE PRESENTATION: A 27-year-old nulliparous Japanese woman at 39 gestational weeks had an uncomplicated vaginal delivery of a 3244-g infant. However, her placenta was not delivered, and we could not remove it manually. Contrast-enhanced magnetic resonance imaging indicated deep myometrial invasion by placental tissue and the whole placenta was strongly enhanced. Seven days post-partum, her serum human chorionic gonadotropin level was 12,656IU/L. Our patient hoped to preserve her uterus for a future pregnancy. She therefore received 13 courses of methotrexate (50mg/week, intravenous injection). Her serum human chorionic gonadotropin level was undetectable 97 days after the first methotrexate injection. At 117 days post-partum, she had a labor-like pain every three minutes and delivered the placenta. Our patient regained normal menses and at follow-up remained in good health. Two years later, she delivered a healthy daughter. CONCLUSION: We should try to detect placenta percreta in high-risk patients by any means. For low-risk patients, we should give a diagnosis swiftly and control any intrauterine infection and massive bleeding.
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Authors | Masato Tamate, Motoki Matsuura, Shutaro Habata, Yushi Akashi, Ryoichi Tanaka, Shinichi Ishioka, Toshiaki Endo, Tsuyoshi Saito |
Journal | Journal of medical case reports
(J Med Case Rep)
Vol. 9
Pg. 232
(Oct 19 2015)
ISSN: 1752-1947 [Electronic] England |
PMID | 26480940
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Chorionic Gonadotropin
- Oxytocics
- Methotrexate
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Topics |
- Adult
- Chorionic Gonadotropin
(blood)
- Female
- Fertility
(physiology)
- Humans
- Magnetic Resonance Imaging
- Methotrexate
(administration & dosage)
- Oxytocics
(administration & dosage)
- Placenta Accreta
(diagnosis, drug therapy)
- Postpartum Period
- Pregnancy
- Term Birth
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