Placenta Percreta in First Trimester after Multiple Rounds of Failed Medical Management for a Missed Abortion
Background. The detection of a morbidly adherent placenta (MAP) in the first trimester is rare. Risk factors such as multiparity, advanced maternal age, prior cesarean delivery, prior myomectomy, placenta previa, or previous uterine evacuation place patients at a higher risk for having abnormal plac...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Obstetrics and Gynecology |
| Online Access: | http://dx.doi.org/10.1155/2017/6070732 |
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| author | Jaimin Shah Eduardo Matta Fernando Acosta Natalia Golardi Cristina Wallace-Huff |
| author_facet | Jaimin Shah Eduardo Matta Fernando Acosta Natalia Golardi Cristina Wallace-Huff |
| author_sort | Jaimin Shah |
| collection | DOAJ |
| description | Background. The detection of a morbidly adherent placenta (MAP) in the first trimester is rare. Risk factors such as multiparity, advanced maternal age, prior cesarean delivery, prior myomectomy, placenta previa, or previous uterine evacuation place patients at a higher risk for having abnormal placental implantation. If these patients have a first trimester missed abortion and fail medical management, it is important that providers have a heightened suspicion for a MAP. Case. A 24-year-old G4P3003 with 3 prior cesarean deliveries underwent multiple rounds of failed medical management for a missed abortion. She had a dilation and curettage that was complicated by a significant hemorrhage and ultimately required an urgent hysterectomy. Conclusion. When patients fail medical management for a missed abortion, providers need to assess the patient’s risk factors for a MAP. If risk factors are present, a series of specific evaluations should be triggered to rule out a MAP and help further guide management. Early diagnosis of a MAP allows providers to coordinate a multidisciplinary treatment approach and thoroughly counsel patients. Ensuring adequate resources and personnel at a tertiary hospital is essential to provide the highest quality of care and improve outcomes. |
| format | Article |
| id | doaj-art-3ca4c680a1f240f583139848d87c4e2b |
| institution | DOAJ |
| issn | 2090-6684 2090-6692 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Obstetrics and Gynecology |
| spelling | doaj-art-3ca4c680a1f240f583139848d87c4e2b2025-08-20T02:39:09ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922017-01-01201710.1155/2017/60707326070732Placenta Percreta in First Trimester after Multiple Rounds of Failed Medical Management for a Missed AbortionJaimin Shah0Eduardo Matta1Fernando Acosta2Natalia Golardi3Cristina Wallace-Huff4Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USADepartment of Diagnostic and Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USADepartment of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USADepartment of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USADepartment of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USABackground. The detection of a morbidly adherent placenta (MAP) in the first trimester is rare. Risk factors such as multiparity, advanced maternal age, prior cesarean delivery, prior myomectomy, placenta previa, or previous uterine evacuation place patients at a higher risk for having abnormal placental implantation. If these patients have a first trimester missed abortion and fail medical management, it is important that providers have a heightened suspicion for a MAP. Case. A 24-year-old G4P3003 with 3 prior cesarean deliveries underwent multiple rounds of failed medical management for a missed abortion. She had a dilation and curettage that was complicated by a significant hemorrhage and ultimately required an urgent hysterectomy. Conclusion. When patients fail medical management for a missed abortion, providers need to assess the patient’s risk factors for a MAP. If risk factors are present, a series of specific evaluations should be triggered to rule out a MAP and help further guide management. Early diagnosis of a MAP allows providers to coordinate a multidisciplinary treatment approach and thoroughly counsel patients. Ensuring adequate resources and personnel at a tertiary hospital is essential to provide the highest quality of care and improve outcomes.http://dx.doi.org/10.1155/2017/6070732 |
| spellingShingle | Jaimin Shah Eduardo Matta Fernando Acosta Natalia Golardi Cristina Wallace-Huff Placenta Percreta in First Trimester after Multiple Rounds of Failed Medical Management for a Missed Abortion Case Reports in Obstetrics and Gynecology |
| title | Placenta Percreta in First Trimester after Multiple Rounds of Failed Medical Management for a Missed Abortion |
| title_full | Placenta Percreta in First Trimester after Multiple Rounds of Failed Medical Management for a Missed Abortion |
| title_fullStr | Placenta Percreta in First Trimester after Multiple Rounds of Failed Medical Management for a Missed Abortion |
| title_full_unstemmed | Placenta Percreta in First Trimester after Multiple Rounds of Failed Medical Management for a Missed Abortion |
| title_short | Placenta Percreta in First Trimester after Multiple Rounds of Failed Medical Management for a Missed Abortion |
| title_sort | placenta percreta in first trimester after multiple rounds of failed medical management for a missed abortion |
| url | http://dx.doi.org/10.1155/2017/6070732 |
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