Conservative Management of Placental Adherence

Abstract

Conservative Management of Placental Adherence

Waralak Yamasmit MD

Sornpin Armarttasn MD

Jariya Lorwatthanasirikul MD

Department of Obstetrics and Gynecology, BMA Medical College and Vajira Hospital

At present, the incidence of placental adherence increases dramatically because the number of cesarean deliveries continues to rise worldwide. Hysterectomy is often recommended as a definite treatment of this condition. However, this procedure is associated with an increased risk of massive bleeding, injury to adjacent organs, and loss of future fertility. Recently, numerous case reports of conservative approach for placental adherence have been published. These management modalities are for example close observation, methotrexate administration and/or selective arterial embolization. Even though many reports demonstrated successful outcomes with subsequent pregnancies, several severe complications also occurred. Thus, conservative management of placental adherence should be considered only in highly selected cases with close monitoring.

Vajira Med J 2008 ; 52 : 175 - 181