Conservative management for adherent placenta after live birth in angular or interstitial pregnancies: A new entity...

Area of Science:

• Reproductive Medicine
• Maternal-Fetal Medicine
• Obstetrics

Background:

• Angular and interstitial pregnancies are rare but can result in live births.
• These pregnancies are often complicated by adherent placentas, typically managed with hysterectomy or corneal resection.

Observation:

• This case series reports on four patients with angular or interstitial pregnancies and adherent placentas.
• Conservative management strategies included observation for spontaneous placental delivery, uterine artery embolization, and manual removal.
• One patient experienced a vaginal delivery with retained placenta, managed expectantly.

Findings:

• The study proposes a new entity: "angular placenta attachment."
• This condition can be diagnosed during cesarean delivery or after vaginal birth when placental separation fails.
• Conservative and expectant management were successfully employed in these cases.

Implications:

• Angular placenta attachment may be a distinct clinical entity.
• Expectant management is a potential conservative approach for adherent placentas in angular or interstitial pregnancies.
• This approach may help avoid hysterectomy in select cases.