Abstract | OBJECTIVE: METHODS: Twenty-four stable patients with placenta accreta were treated with MTX. Beta-hCG values, vascular indices of the residual placenta, and other clinical characteristics were collected prospectively and were compared between the success and failure groups. RESULTS: After MTX management, the residual placentas were expulsed spontaneously in 33.3% of the patients. This was done through dilatation and curettage (D & C) in 45.8% of the patients. The residuals in the uterine wall were completely absorbed within 5.7 months. In the patients who were successfully treated with MTX, their beta-hCG values and vascular indices of the placentas decreased faster than those of failure patients (P < 0.05). Those (20.8%) failing MTX management and subsequent D & C showed that their vascular indices persisted high levels and some even experienced elevations despite significantly decreased hCG values. CONCLUSIONS: MTX management, when the beta-hCG value and vascular indices of placenta decreased significantly, is a conservative option for a stable patient with placenta accreta in China. 3D power Doppler ultrasound should be utilized for the follow-up of this condition.
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Authors | Kaiqing Lin, Jiale Qin, Kaihong Xu, Wen Hu, Jun Lin |
Journal | Archives of gynecology and obstetrics
(Arch Gynecol Obstet)
Vol. 291
Issue 6
Pg. 1259-64
(Jun 2015)
ISSN: 1432-0711 [Electronic] Germany |
PMID | 25501835
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Chorionic Gonadotropin, beta Subunit, Human
- Methotrexate
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Topics |
- Adult
- China
- Chorionic Gonadotropin, beta Subunit, Human
(metabolism)
- Dilatation and Curettage
(methods)
- Female
- Follow-Up Studies
- Humans
- Methotrexate
(therapeutic use)
- Placenta
(diagnostic imaging, pathology)
- Placenta Accreta
(diagnostic imaging, drug therapy)
- Pregnancy
- Prospective Studies
- Ultrasonography
- Uterus
(diagnostic imaging)
- Young Adult
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