P08.04: Ultrasound follow-up of patients treated with monsels solution for placenta accreta

Abstract

In summary a combined therapeutic approach employing local and subsequent parenteral injection of MTX with close follow up of the gradually diminishing vascularization around the chorionic sac is a reasonable therapeutic approach for the increasing number of first trimester CSPs. Determination of vascularity seems to be an important measure of healing in addition of the βhCG.Patients after Cesarean deliveries, should be encouraged to present between 6-8 weeks of a subsequent pregnancy for possible and early detection of this threatening entity. P08.02The role of ultrasound in prenatal diagnoss of the pathological invasion of placenta into the myometrium M. Kotori, F. Muhaxhiri, S. Lulaj Department of Gynecology and Obstetric, University Clinical Center, Prishtina, AlbaniaIntroduction: The placenta accreta, increta and percreta are the pathological features of the placenta insertion in myometrium. They are present in 1 : 2500 of pregnancies, in 4-10% of the cases with placenta praevia. Based on the serious obstetric complications which can appear from the pathological insertion of the placenta such as massive bleeding, hemorrhagic shock, the need for transfusion, for hysterectomy, infections, intraoperative lesions of the urinary bowel, and maternal death, this is the main need and interest of the prenatal diagnosing of this pathology. Objective: To investigate the possibility of prenatal diagnosing of this pathology with the ultrasound. Material and methods: In the study are included 84 pregnant women with the low insertion of placenta and with bleeding in the second and third trimester. They were examined with ultrasound with abdominal probe 3.5 MHz for searching of the characteristic signs of the pathological insertion of placenta in the depth of myometrium such as: the absent of the hypoehogenic retroplacentar-myometrial zone, the absent of the smooth surface with urinary bowel, the presence of the vascular lacunas (''Swiss cheese''). Results: From the 6 cases with placenta praevia accreta and increta, 5 (83.3%) were diagnosed in prenatal period with the ultrasound. Conclusions: The ultrasound examinations enable the prenatal diagnosing of the pathological invasion of the placenta in the myometrium and help us in preoperative preparation and intraoperative management.