孕中期妊娠丢失后胎盘植入的期待治疗：一例病例报告及简短综述

Fumagalli Diletta, Bignardi Tommaso, Vanzulli Angelo, Corbella Paola Francesca, Meroni Mario Giuseppe, Interdonato Maria Lieta

Department School of Medicine and Surgery, Obstetrics and Gynecology Branch, University of Milano-Bicocca, Milan, Italy.

Department of Obstetrics and Gynaecology, Niguarda Ca' Granda Hospital, Milan, Italy.

Case Rep Perinat Med. 2022 Feb 1;11(1):20210008. doi: 10.1515/crpm-2021-0008. eCollection 2022 Jan.

OBJECTIVES

Placenta accreta spectrum (PAS) disorders are a significant cause of maternal morbidity and mortality. Traditionally women with PAS are offered surgery, while expectant management is still considered investigational.

CASE PRESENTATION

We present a case of expectant management of PAS after pregnancy loss at 19-weeks. PAS was suspected at sonography and confirmed by MRI. Patient was offered expectant management to preserve fertility. This consisted of leaving the placenta , followed by in- and out-patient clinical and sonographic examinations and blood tests. After five weeks placental detachment occurred without major complications.

CONCLUSIONS

Our report suggests that expectant management could be a safe option in selected cases of PAS after mid-trimester pregnancy loss. We recommend expectant management should be offered in referral centers for PAS.