Conservative treatment of placenta increta with methotrexate

Crespo, R.; Lapresta, M.; Madani, Bahar

doi:10.1016/j.ijgo.2005.06.028

Cited by 24 publications

(19 citation statements)

References 4 publications

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“…We identified 53 articles including one prospective cohort study, 2 retrospective cohort studies, 10 case series and 40 case reports with cumulative describing 121 patients [10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62]. Our inclusion criteria led to exclusion of 33 patients: 1 patient due to another diagnosis (un-ruptured interstitial corneal pregnancy) [32], 24 patients due to lack of exact reported data [17,51], 4 patients due to initial total hysterectomy [14,17,61], and finally another 4 patients due to other conservative modalities without MTX administration [14,23,42] (fig.…”

Section: Resultsmentioning

confidence: 99%

Management of Abnormal Placenta Implantation with Methotrexate: A Review of Published Data

Farasatinasab

Moghaddas

Dashti-Khadivaki

et al. 2016

Gynecol Obstet Invest

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Abnormally invasive placenta is characterized by direct attachment of chorionic villi to the uterine wall. This adherent placenta traditionally has been managed by peripartum hysterectomy. Nowadays, there is a lot of interest toward gradual shift from traditional management of invasive placentation to conservative ones leaving the placenta in situ to avoid the surgical morbidity of hysterectomy and loss of future fertility. Administration of methotrexate (MTX), as an adjunctive antimetabolite drug, resulted in conflicting data during conservative management of abnormal placentation. This review assessed all published data on efficacy and safety of MTX therapy as conservative management of invasive placentation. Fifty-three articles including one prospective cohort study, 2 retrospective cohort studies, 10 case series and 40 case reports were identified. Conservative management has beneficial effects on the avoidance of major surgery with the consequent morbidity and the preservation of future fertility. Infection and vaginal bleeding were main complications of MTX therapy. Although MTX therapy may result in accelerated involution or expulsion of placenta and has some beneficial effects on hemorrhagic events, but there is not enough evidence on its efficacy and safety to recommend its routine uses in all cases of invasive placenta.

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Section: Resultsmentioning

confidence: 99%

Management of Abnormal Placenta Implantation with Methotrexate: A Review of Published Data

Farasatinasab

Moghaddas

Dashti-Khadivaki

et al. 2016

Gynecol Obstet Invest

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“…Patient passed fleshy mass 7 months post-delivery. 27 Sentilhis et al concluded that failure rate of conservative management was 22% which required hysterectomy, either primary or delayed, mostly for severe haemorrhage. Although conservative treatment is successful in uterine preservation but there are chances of severe maternal morbidity in the form of sepsis including septic shock, peritonitis, uterine necrosis, fistula, injury to the adjacent organs, acute pulmonary oedema, acute renal failure, deep vein thrombophlebitis, pulmonary oedema and death.…”

Section: Discussionmentioning

confidence: 99%

A rare case report of hysterotomy for retained placenta accreta in bicornuate uterus

Sharma

Gupta

Chaudhary

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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“…In another case report by Crespo et. al, the patient received 4 doses of methotrexate intramuscularly every other day, alternating with 4 doses of 15 mg folinic acid to reduce placental residual tissue which was retained in a cesarean delivery and seven months later, she passed a fleshy tissue mass vaginally then a subsequent ultrasonograhic examination documented an empty uterine cavity (13). In our case, we tried to avoid severe haemorrhage and bladder injury by leaving the placental tissue inside the uterus.…”

Section: Discussionmentioning

confidence: 92%

Conservative management of placenta previa percreta by leaving placental tissue in situ with arterial ligation and adjuvant methotrexate therapy

Çırpan

Sanhal

Yücebilgin

et al. 2011

J Turkish German Gynecol Assoc

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Placenta percreta is one of the life-threatening conditions in modern obstetrics. The rising caesarean section rate means rising placenta percreta rate. Treatment strategies range from a caesarean hysterectomy to leaving the placenta in situ with or without internal iliac artery ligation/uterine artery embolisation and/or methotrexate therapy. We describe a case of placenta previa percreta which we managed successfully with conservative modalities. (J Turkish-German Gynecol Assoc 2011; 12: 127-9) Key words: Placenta percreta/accreta, methotrexate, conservative management Received: 15 May, 2010 Accepted: 3 August, 2010Plasenta perkreata modern obstetrideki hayatı tehdit eden patolojilerden biridir. Artan sezaryen doğum oranı artan plasenta perkreata oranı anlamına gelmektedir. Tedavi stratejileri sezaryen histerektomiden plasentanın içeride bırakılması veya internal iliak arter ligasyonu/uterin arter embolizasyonu ve/veya metotreksat tedavisine kadar uzanmaktadır. Bu yazıda konservatif yöntemler kullanarak başarılı şekilde yönettiğimiz bir plasenta previa perkreata tanılı olguyu takdim etmekteyiz. (J Turkish-German Gynecol Assoc 2011; 12: 127-9) Anahtar kelimeler: Plasenta perkreata/akreata, metotreksat, konservatif yönetim

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Conservative treatment of placenta increta with methotrexate

Cited by 24 publications

References 4 publications

Management of Abnormal Placenta Implantation with Methotrexate: A Review of Published Data

Management of Abnormal Placenta Implantation with Methotrexate: A Review of Published Data

A rare case report of hysterotomy for retained placenta accreta in bicornuate uterus

Conservative management of placenta previa percreta by leaving placental tissue in situ with arterial ligation and adjuvant methotrexate therapy

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