World Journal of Anemia

Register      Login

VOLUME 2 , ISSUE 1 ( January-March, 2018 ) > List of Articles


A Rare Case of Morbidly Adherent Placenta in a Young Primipara managed Conservatively

Balwinder Kaur, Manjeet Kaur, Beant Singh, Santosh Kumari

Keywords : Manual removal of the placenta, Methotrexate, Piecemeal, Placenta accreta

Citation Information : Kaur B, Kaur M, Singh B, Kumari S. A Rare Case of Morbidly Adherent Placenta in a Young Primipara managed Conservatively. World J Anemia 2018; 2 (1):36-38.

DOI: 10.5005/jp-journals-10065-0027

License: CC BY-ND 3.0

Published Online: 01-12-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Placenta accreta syndrome is any placental implantation with abnormally firm adherence to myometrium because of partial or complete absence of decidua basalis and imperfect development of fibrinoid and Nitabuch's layers. We report a case of densely adherent placenta in a 21-year-old primipara without any other risk factor. She was referred from CHC Barnala following preterm vaginal delivery at 36 weeks 3 days with two failed attempts of manual removal of the placenta (MROP) where only a few bits of placenta could be removed. The ultrasonography (USG) confirmed retained adherent placenta with increased vascularity on color Doppler. Patient was managed conservatively with 50 mg inj methotrexate intramuscularly, single dose given followed by placental expulsion 10 days later. Repeat USG confirmed normal empty uterus. Patient was discharged in satisfactory condition.

PDF Share
  1. American College of Obstetricians and Gynecologists (ACOG). Placenta accreta. Committee Opinion No. 529. Obstet Gynecol 2012;120:207-211.
  2. Khadra M, Obhrai M, Keriakos R, Johanson R. Placenta percreta revisited. J Obst Gynaecol 2002 Nov;22(6):689.
  3. Bennett MJ, Sen RC. ‘Conservative’ management of placenta praevia percreta: report of two cases and discussion of current management options. Aust N Z J Obstet Gynaecol 2003 Jun;43(3):249-251.
  4. Adair SR, Elamin D, Tharmaratnam S. Placenta increta; conservative management—a successful outcome. Case report and literature review. J Matern Fetal Neonatal Med 2004 Apr;15(4):275-278.
  5. Cunningham, GF.; Leveno, KJ.; Bloom, SL.; Spong, CY.; Dashe, JS.; Hoffman, BL.; Casey, BM.; Sheffield, JS. Obstetrical hemorrhage. In: Williams obstetrics. 24th ed. New York: McGraw Hill; 2014. pp. 804-807.
  6. Tong SY, Tay KH, Kwek YC. Conservative management of placenta accreta: review or three cases. Singapore Med J 2008 Jun;49(6):e156-e159.
  7. Riggs JC, Jahshan A, Schiavello HJ. Alternative conservative management of placenta accrete. A case report. J Reprod Med 2000 Jul;45(7):595-598.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.