Magnetic resonance imagining (MRI) and serial β-human chorionic gonadotrophin (β-hCG) follow up for placenta percreta
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Placenta percreta is a rare obstetric condition associated with life-threatening hemorrhage. MR imaging has a role in prenatal diagnosis of these cases. However, its role in the postnatal diagnosis and in the follow up yet to be established.
A 33-year-old patient has adherent placenta following spontaneous delivery at 37 weeks gestation. MR imaging diagnosed placenta percreta. Intramuscular methotrexate treatment was initiated with follow up with serial β-human chorionic gonadotrophin (β-hCG). In spite of dropping of the level of β-hCG, the trophoblastic tissue was still present 6 weeks postnatally where the patient complained of vaginal bleeding where she opted to abdominal hysterectomy.
Patients who are suitable for non-surgical therapy, T2-weighted MR imaging may, in conjunction with serial β-hCG assays, provide an alternative treatment modality for cases of placenta percreta.
KeywordsMRI Placenta percreta β-hCG
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