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Methotrexate management for placenta accreta: a prospective study.

AbstractOBJECTIVE:
To observe efficacy following methotrexate (MTX) management in women with placenta accreta.
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.
AuthorsKaiqing Lin, Jiale Qin, Kaihong Xu, Wen Hu, Jun Lin
JournalArchives of gynecology and obstetrics (Arch Gynecol Obstet) Vol. 291 Issue 6 Pg. 1259-64 (Jun 2015) ISSN: 1432-0711 [Electronic] Germany
PMID25501835 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Chorionic Gonadotropin, beta Subunit, Human
  • Methotrexate
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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