Persistent placenta increta: a complication of conservative management of presumed placenta accreta

Recent reports have advocated conservative management rather than hysterectomy for placenta increta and its related conditions, placenta accreta and percreta. We report an unusual case of placenta increta in which initial conservative therapy for a presumed placenta accreta failed and hysterectomy was performed 6 months postpartum.

A 32-year-old woman, gravida 2, para 2, was referred 5 months after a repeat cesarean delivery and bilateral tubal interruption for evaluation of an intrauterine mass. A presumed placenta accreta noted at delivery had been managed conservatively. Hysterectomy was performed, and pathologic evaluation was consistent with a retained placenta increta.

Persistent placental tissue is a potential complication of conservative management of an abnormally adherent placenta.