Obstet Gynecol Sci.  2013 May;56(3):194-197.

Conservative multidisciplinary management of placenta percreta following in vitro fertilization

• Shim JY
• Hong SY
• Won HS
• Lee PR
• Kim A

Abstract

Placenta percreta is an extremely rare and the most severe form of placental invasion, that is associated with severe maternal morbidity and mortality. We report a case of nulliparous woman who underwent 10 cycles of in vitro fertilization (IVF) without any known risk factors. We conserved her uterus by spontaneous vaginal delivery, leaving the placenta in situ, pelvic arterial embolization, and primary resection of the remaining placental tissues. This case demonstrates that repetitive IVF is a possible risk factor for placental invasion, and that conservation of the uterus can be achieved in such cases using a multidisciplinary approach.

Keyword

Assisted reproductive technics; Magnetic resonance imaging; Placenta percreta; Uterine artery embolization; Uterine rupture

MeSH Terms

Female
Fertilization in Vitro
Humans
Magnetic Resonance Imaging
Placenta
Placenta Accreta
Reproductive Techniques, Assisted
Risk Factors
Uterine Artery Embolization
Uterine Rupture
Uterus

Figure

• 

  Fig. 1 (A) Coronal magnetic resonance imaging view of the pelvis. The placenta is located in the right fundal portion of the gravid uterus, penetrates the myometrium, and extends into the peritoneal cavity. (B) Fat-saturated axial image. High intensity signals are evident along right fundal portion of the uterus, indicating a peri-uterine hematoma.

• 

  Fig. 2 Photographs showing the ruptured uterus and protruding placental tissue (A), and the repaired uterus, after removal of the placenta (B).

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