Postpartum monitoring of retained placenta. Two cases of abnormally adherent placenta.
Summary of "Postpartum monitoring of retained placenta. Two cases of abnormally adherent placenta."
To save fertility, hysterectomy may be avoided with abnormal placental adherence by leaving the placenta in situ. Several reports support this strategy, but no reports are available on optimal follow-up strategies. We present two women with conservative treatment of placenta accreta and describe the prospective monitoring of the clinical course, placental regression, and recovery of the uterine anatomy using serial sonography, hysteroscopy and magnetic resonance imaging. There was no postpartum hemorrhage. Menstrual cyclicity resumed within 18 weeks. The human chorionic gonadotropin serum levels normalised within 10 weeks, whereas, regression of placenta tissue was slow and continued up to nine months after delivery. In both cases placental remnants persisted, in one woman they were removed and uterine anatomy restored. She had a subsequent uneventful pregnancy afterwards. The presented systematic follow-up provides tools to monitor and treat other women in similar ways.
Affiliation
Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands.
Journal Details
This article was published in the following journal.
Name: Acta obstetricia et gynecologica Scandinavica
ISSN: 1600-0412
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22731843
- DOI: http://dx.doi.org/10.1111/j.1600-0412.2012.01494.x
Medical and Biotech [MESH] Definitions
Placenta, Retained
A placenta that fails to be expelled after BIRTH of the FETUS. A PLACENTA is retained when the UTERUS fails to contract after the delivery of its content, or when the placenta is abnormally attached to the MYOMETRIUM.
Placenta Accreta
Abnormal placentation in which all or parts of the PLACENTA are attached directly to the MYOMETRIUM due to a complete or partial absence of DECIDUA. It is associated with POSTPARTUM HEMORRHAGE because of the failure of placental separation.
Placenta Diseases
Pathological processes or abnormal functions of the PLACENTA.
Placenta Previa
Abnormal placentation in which the PLACENTA implants in the lower segment of the UTERUS (the zone of dilation) and may cover part or all of the opening of the CERVIX. It is often associated with serious antepartum bleeding and PREMATURE LABOR.
Placenta
A highly vascularized mammalian fetal-maternal organ and major site of transport of oxygen, nutrients, and fetal waste products. It includes a fetal portion (CHORIONIC VILLI) derived from TROPHOBLASTS and a maternal portion (DECIDUA) derived from the uterine ENDOMETRIUM. The placenta produces an array of steroid, protein and peptide hormones (PLACENTAL HORMONES).
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