Placenta Previa Partial Accreta Managed Successfully with Lower Segment Caesarean and Methotrexate Injection QD01-QD03
Dr. Gowri Dorairajan,
2nd Floor, Women and Child Block, Jawaharlal Nehru Institute of Postgraduate
Medical Education and Research, Puducherry-605006, India.
Placenta accreta is defined as an abnormal trophoblast invasion or pathologic adherence of part or all the placenta into the myometrium of the uterine wall. Patients with complete placental adhesive disorders are more likely to require classical caesarean and insitu hysterectomy or delayed hysterectomy during the postpartum period. The management of partially adhered placenta is controversial. We report a patient who was diagnosed to have partial adherence of the central previa placenta with intrauterine fetal demise. She was successfully managed by lower segment cesarean section after bilateral uterine artery ligation followed by excision of the non-adhered placenta and postoperative methotrexate. The operative and postoperative management is detailed. Lower Segment Caesarean Section (LSCS) and postoperative methotrexate should be considered a feasible and safe option for a woman with partial adhered placenta previa in the set up of a tertiary institute with intensive care unit and blood bank.