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Methotrexate management for placenta accreta: a prospective study

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To observe efficacy following methotrexate (MTX) management in women with placenta accreta.

Methods

Twenty-four stable patients with placenta accreta were treated with MTX. Beta-hCG values, vascular indices of the residual placenta, and other clinical characteristics were collected prospectively and were compared between the success and failure groups.

Results

After MTX management, the residual placentas were expulsed spontaneously in 33.3 % of the patients. This was done through dilatation and curettage (D & C) in 45.8 % of the patients. The residuals in the uterine wall were completely absorbed within 5.7 months. In the patients who were successfully treated with MTX, their beta-hCG values and vascular indices of the placentas decreased faster than those of failure patients (P < 0.05). Those (20.8 %) failing MTX management and subsequent D & C showed that their vascular indices persisted high levels and some even experienced elevations despite significantly decreased hCG values.

Conclusions

MTX management, when the beta-hCG value and vascular indices of placenta decreased significantly, is a conservative option for a stable patient with placenta accreta in China. 3D power Doppler ultrasound should be utilized for the follow-up of this condition.

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Acknowledgments

We appreciate the financial support of the Nature Science Foundation of Zhejiang Province (Y2110128). We would like to acknowledge the members of Ultrasound Department and Obstetrics Department for making their data available.

Conflict of interests

The authors declare that there are no conflicts of interest. We appreciate the financial support of the Nature Science Foundation of Zhejiang Province (Y2110128). We state that we have had full control of all primary data and that we agree to allow the Journal to review our data if requested.

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Authors and Affiliations

  1. Department of Gynecology, Women’s Hospital, Zhejiang University School of Medicine, 1 Xueshi Road, Hangzhou, 310006, Zhejiang, People’s Republic of China

    Kaiqing Lin, Kaihong Xu, Wen Hu & Jun Lin

  2. Department of Ultrasound, Women’s Hospital, Zhejiang University School of Medicine, 1 Xueshi Road, Hangzhou, 310006, Zhejiang, People’s Republic of China

    Jiale Qin

Authors
  1. Kaiqing Lin
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  2. Jiale Qin
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  3. Kaihong Xu
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  4. Wen Hu
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  5. Jun Lin
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Corresponding author

Correspondence to Jun Lin.

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Lin, K., Qin, J., Xu, K. et al. Methotrexate management for placenta accreta: a prospective study. Arch Gynecol Obstet 291, 1259–1264 (2015). https://doi.org/10.1007/s00404-014-3573-1

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  • DOI: https://doi.org/10.1007/s00404-014-3573-1

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