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Placenta increta after hysteroscopic myomectomy
Emily Mathiesen1, Mark Hohenwalter, Zainab Basir
1Department of Obstetrics and Gynecology, Medical College of Wisconsin Affiliated Hospitals, and the Maternal Fetal Medicine Department, Department of Radiology, and the Pathology Department, Medical College of Wisconsin, Milwaukee, Wisconsin.
Obstetrics and Gynecology
|July 26, 2013
Summary
Women with a history of uterine leiomyoma treatment, like hysteroscopic myomectomy, face increased risks for abnormal placentation. Early imaging and multidisciplinary care are crucial for reducing maternal and fetal complications.
Area of Science:
- Reproductive Medicine
- Maternal-Fetal Medicine
- Gynecologic Surgery
Background:
- Abnormal placentation, including placenta accreta, is frequently linked to prior cesarean deliveries.
- Uterine leiomyomas and their treatments are recognized risk factors for placenta accreta.
Observation:
- A 34-year-old woman with a history of hysteroscopic myomectomy developed a suspected placenta percreta in a subsequent pregnancy.
- Advanced imaging modalities, including ultrasonography and magnetic resonance imaging, were used for diagnosis.
Findings:
- The patient's history of hysteroscopic myomectomy was a significant factor in the abnormal placentation diagnosis.
- Multidisciplinary management facilitated a successful delivery with minimal maternal morbidity.
Implications:
- Hysteroscopic myomectomy and other uterine leiomyoma treatments increase the risk of abnormal placentation.
- Pre-pregnancy imaging is recommended for patients with a history of uterine leiomyoma treatment.
- Coordinated multidisciplinary care is essential to mitigate maternal and fetal risks associated with abnormal placentation.
