3D volume for monitoring the efficacy of methotrexate on placenta accrete: A case report.

Choi, Youn Jin; Park, In Yang; Shin, Jong Chul; Jang, Dong Gyu

doi:2010.53.5.422

Case Report

Korean Journal of Obstetrics & Gynecology 2010;53(5):422-427.
DOI: https://doi.org/10.5468/kjog.2010.53.5.422 Published online May 1, 2010.

3D volume for monitoring the efficacy of methotrexate on placenta accrete: A case report.

Youn Jin Choi, In Yang Park, Jong Chul Shin, Dong Gyu Jang

Department of Obstetrics and Gynecology, The Catholic University of Korea School of Medicine, Seoul, Korea. nigothemo@catholic.ac.kr

Abstract

Placenta accreta is a rare condition in which the placenta abnormally attaches to myometrium. It is associated with a high maternal morbidity and mortality rate due to massive hemorrhage, perforation, and infection. It is very rare to have placenta accreta in first trimester. Traditionally, hysterectomy has been the most performed management in abnormal placentation. Because it cannot preserve fertility, the conservative management such as methotrexate usage, and uterine artery embolization are pursued, recently. For monitoring the efficacy of the conservative management, serum human chorionic gonadotrophin (hCG) level has been used, however, low hCG does not always reflect the success of the treatment. 3D-ultrasonography is a new method to pursue the effect of conservative care, by measuring the volume of placenta accreta left in situ. We present a case of a 23-year-old patient with retained placenta accreta following dilatation and curettage, under a successful methotrexate treatment. The effect of methotrexate usage was evaluated by 3D-volume.

Key Words: Placenta accreta, Methotrexate, 3D-volume