Conservative Management of Placenta Previa Percreta in a Jehovah's Witness
- 1 May 2005
- journal article
- case report
- Published by Ovid Technologies (Wolters Kluwer Health) in Obstetrics & Gynecology
- Vol. 105 (5), 1247-1250
- https://doi.org/10.1097/01.aog.0000157762.65732.1b
Abstract
Hemorrhage is a serious threat with placenta accreta, often requiring aggressive operative intervention by hysterectomy and resuscitative measures with large-volume blood replacement to ensure survival. Refusal to accept transfusion makes management especially difficult. We report a Jehovah's Witness patient who had 9 previous cesarean deliveries and presented with anemia and placenta previa percreta invading the bladder wall. Management objectives were to enhance the patient's status, using erythropoietin and autologous transfusion, and to minimize the chance of hemorrhage by prophylactic uterine artery embolization. The placenta was left in situ after the delivery with no untoward consequences. Methotrexate was held in readiness, but was not required as adjuvant therapy. Effective care of such patients requires close collaborative team effort and advanced planning to ensure a good outcome.Keywords
This publication has 8 references indexed in Scilit:
- Postpartum Hemorrhage: New Management OptionsClinical Obstetrics and Gynecology, 2002
- Failure of methotrexate and internal iliac balloon catheterization to manage placenta percretaObstetrics & Gynecology, 2002
- Three-dimensional color power Doppler imaging in the assessment of uteroplacental neovascularization in placenta previa increta/percretaAmerican Journal of Obstetrics and Gynecology, 2001
- Placenta percreta with bladder invasion managed by arterial embolization and manual removal after cesareanObstetrics & Gynecology, 2000
- Placenta previa: A 22-year analysisAmerican Journal of Obstetrics and Gynecology, 1999
- Placenta Percreta Invading the Bladder Causing Exsanguinating HemorrhageInternational Urogynecology Journal, 1999
- Placenta accreta: evaluation with color Doppler US, power Doppler US, and MR imaging.Radiology, 1997
- The management of placenta percreta: Conservative and operative strategiesAmerican Journal of Obstetrics and Gynecology, 1996