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Related Experiment Video

Updated: Jul 2, 2026

Comprehensive Evaluation of the Effectiveness and Safety of Placenta-Targeted Drug Delivery Using Three Complementary Methods
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Partial placenta increta and methotrexate therapy: three case reports.

S Pinho1, S Sarzedas, S Pedroso

  • 1Department of Obstetrics, Gamrcia de Orta Hospital, Almada, Portugal. s.pinho@netcabo.pt

Clinical and Experimental Obstetrics & Gynecology
|August 30, 2008
PubMed
Summary

Methotrexate offers a potential conservative management for placenta increta, reducing retained placental size and vascularization. This approach led to undetectable beta-hCG levels in three partial placenta increta cases.

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Area of Science:

  • Obstetrics and Gynecology
  • Reproductive Medicine

Background:

  • Placenta accreta spectrum disorders involve abnormal placental adherence to the uterine wall, complicating approximately 1 in 2,500 deliveries.
  • These conditions are associated with significant maternal morbidity and mortality, including hemorrhage, uterine perforation, infection, and infertility.
  • Conservative management options for placenta accreta are limited, with scarce reported experience on methotrexate treatment.

Observation:

  • This study describes three cases of partial placenta increta managed conservatively with methotrexate.
  • Patients were monitored using clinical surveillance, serum beta human chorionic gonadotrophin (beta-hCG) levels, and imaging techniques such as ultrasonography and magnetic resonance imaging.

Findings:

  • Conservative management with methotrexate resulted in undetectable serum beta-hCG levels in all three cases.
  • A decrease in the size of retained partial placenta was observed.
  • Imaging revealed undetectable vascularization of the retained placental tissue post-treatment.

Implications:

  • Methotrexate may represent a viable conservative treatment option for selected cases of placenta increta, potentially preserving fertility.
  • Further research is warranted to establish the efficacy and safety profile of methotrexate in managing placenta accreta spectrum disorders.
  • This approach could offer an alternative to hysterectomy in women desiring future fertility.