[Case report: seventeen year old primipara with placenta increta, treated with methotrexate]

A seventeen year old girl in her first pregnancy had a normal vaginal delivery of a healthy male infant. Afterwards, the placenta was retained and subsequent MRI and ultrasound confirmed placenta increta. There was no history of prior uterine surgery. Conservative treatment with methotrexate was chosen in order to conserve the uterus. During the following nine weeks after birth remnants of the placenta were gradually expelled from the uterus. Subsequently MRI and ultrasound confirmed an empty uterus. When the diagnosis of placenta increta is confirmed the current recommendation is hysterectomy to prevent life threatening bleeding or infection. Conservative treatments have been described to avoid hysterectomy with methotrexate as being one of the options.