Retrospective analysis: Conservative treatment of placenta increta with methotrexate.
J Obstet Gynaecol Res
; 44(5): 907-913, 2018 May.
Article
en En
| MEDLINE
| ID: mdl-29484784
ABSTRACT
AIM:
To evaluate the efficacy of conservative treatment with methotrexate against placenta increta by two different routes of administration through retrospective analysis.METHODS:
A total of 54 women diagnosed with placenta increta after vaginal delivery were enrolled in this retrospective study. The participants accepted conservative management with methotrexate through either intravenous injection or local multi-point injection under ultrasound guidance. The treatment was considered effective if no hysterectomy was mandatory during the follow-up period.RESULTS:
Out of the 54 cases, 21 patients were treated with methotrexate intravenously (group 1), and 33 patients received local multi-point injection to the placenta increta under ultrasound guidance (group 2). No maternal death occurred. In group 1, 10 patients expelled the placentas spontaneously, 7 patients underwent uterine curettage and 4 patients underwent hysterectomy for uncontrollable post-partum hemorrhage and infection. In group 2, 25 patients expelled placentas spontaneously and 8 patients underwent uterine curettage with no incidence of hysterectomy. The success rate in group 1 and group 2 was 17/21 and 33/33, respectively. The average time of the spontaneous placenta expulsion was 79.13 ± 29.87 days in group 1 and 42.42 ± 31.83 days in group 2.CONCLUSION:
Local multi-point methotrexate injection under ultrasound guidance is a better alternative for patients with placenta increta, especially for preserving fertility.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Placenta Accreta
/
Abortivos no Esteroideos
/
Metotrexato
/
Ultrasonografía Intervencional
/
Tratamiento Conservador
Tipo de estudio:
Guideline
/
Observational_studies
Límite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
J Obstet Gynaecol Res
Asunto de la revista:
GINECOLOGIA
/
OBSTETRICIA
Año:
2018
Tipo del documento:
Article
País de afiliación:
China