Successful treatment of Placenta Percreta through a combinatorial treatment involving a Bakri Balloon and Methotrexate--a case report.

Abstract

Placental percreta is a complication involving an abnormally deep placental attachment to the myometrium, resulting in obstetric hemorrhage and peripartum hysterectomy A 38-year-old pregnant woman, with a history of 2 Cesarean births, myomectomy 9 pregnancies, and 6 spontaneous abortions, was admitted after experiencing intrauterine fetal death, which occurred at 19 weeks gestation. The patient was referred to our institution after 8 days of unsuccessful medical treatment. Doppler ultrasonography and vacuum curettage revealed possible signs of abnormal placentation. Because of the unsuccessful separation of the placenta and massive bleeding, we used a Bakri Balloon to treat excessive bleeding during the acute phase, followed by the conservative administration of parenteral methotrexate to treat the spontaneous involution of the placenta at 7 weeks of conservative therapy Bakri Balloon and methotrexate application to treat bleeding after curettage is a useful choice in placenta percreta and hemorrhage after abortion.

• Authors: Nermin Akdemir, Arif Serhan Cevrioğlu, Selçuk Özden, Yasemin Gündüz, Göken Ilhan
• Journal: Ginekologia polska (Ginekol Pol) Vol. 86 Issue 8 Pg. 631-4 (Aug 2015) ISSN: 0017-0011 [Print] Poland
• PMID: 26492714 (Publication Type: Case Reports, Journal Article)

Chemical References

• Abortifacient Agents, Nonsteroidal
• Methotrexate

Topics

• Abortifacient Agents, Nonsteroidal (administration & dosage)
• Abortion, Induced (adverse effects, methods)
• Blood Loss, Surgical (prevention & control)
• Combined Modality Therapy
• Female
• Humans
• Methotrexate (administration & dosage)
• Placenta Accreta (surgery)
• Postpartum Hemorrhage (etiology, prevention & control)
• Pregnancy
• Treatment Outcome
• Uterine Balloon Tamponade (methods)