Aim: To report the occurrence of an adherent placenta in the absence of prior risk factors and discuss the various management options especially conservative management.
Background: Morbidly adherent placenta (MAP) refers to any placental implantation with abnormally firm adherence to myometrium. Morbid adherence of placenta has evolved into one of the most serious problems in obstetrics. The incidence has increased tenfold in the past 50 years due to the increasing number of cesarean sections and has reached seemingly epidemic proportions. The American College of Obstetricians and Gynaecologists cites the incidence to be as high as 1 in 533 deliveries.
Case report: We report a case of the placenta increta in a primigravida successfully managed by a conservative method with injection methotrexate followed by uterine artery embolization.
Conclusion: Selected cases of the morbidly adherent placenta can be successfully managed conservatively. With proper selection of cases and adequate monitoring, modern conservative techniques have made preservation of fertility possible.
Clinical significance: Only four cases of the adherent placenta in primigravida without any risk factors have been reported in the literature. Fertility preservation is a major concern in the management of these patients.
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