Korean J Obstet Gynecol.  2010 May;53(5):422-427. 10.5468/kjog.2010.53.5.422.

3D volume for monitoring the efficacy of methotrexate on placenta accrete: A case report

Affiliations
  • 1Department of Obstetrics and Gynecology, The Catholic University of Korea School of Medicine, Seoul, Korea. nigothemo@catholic.ac.kr

Abstract

Placenta accreta is a rare condition in which the placenta abnormally attaches to myometrium. It is associated with a high maternal morbidity and mortality rate due to massive hemorrhage, perforation, and infection. It is very rare to have placenta accreta in first trimester. Traditionally, hysterectomy has been the most performed management in abnormal placentation. Because it cannot preserve fertility, the conservative management such as methotrexate usage, and uterine artery embolization are pursued, recently. For monitoring the efficacy of the conservative management, serum human chorionic gonadotrophin (hCG) level has been used, however, low hCG does not always reflect the success of the treatment. 3D-ultrasonography is a new method to pursue the effect of conservative care, by measuring the volume of placenta accreta left in situ. We present a case of a 23-year-old patient with retained placenta accreta following dilatation and curettage, under a successful methotrexate treatment. The effect of methotrexate usage was evaluated by 3D-volume.

Keyword

Placenta accreta; Methotrexate; 3D-volume

MeSH Terms

Animals
Chorion
Dilatation and Curettage
Female
Fertility
Hemorrhage
Humans
Hysterectomy
Methotrexate
Mice
Myometrium
Placenta
Placenta Accreta
Placenta, Retained
Placentation
Pregnancy
Pregnancy Trimester, First
Uterine Artery Embolization
Young Adult
Methotrexate
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