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

Erika Nakatsuka, Kazuya Mimura, Masayuki Endo, Tatsuya Miyake, Aiko Kakigano, Shinya Matsuzaki, Yoko Kawanishi, Takuji Tomimatsu, Tadashi Kimura
2020 Taiwanese Journal of Obstetrics & Gynecology  
Angular and interstitial pregnancies have been reported with live births and are often complicated by adherent placentas. Most cases had been treated with hysterectomy or corneal resection. We successfully treated four patients with conservative management (including one reported previously). Case 1 had a vaginal delivery, but the placenta remained attached. We maintained the patient under observation and delivered the placenta on postpartum day 9. Case 2 underwent a C-section. Uterine artery
more » ... bolization controlled the hemorrhage without placenta removal. The placenta had disappeared by postpartum day 136. Case 3 underwent a C-section. The right uterine angle, where the placenta was attached, was bulging. We manually removed the placenta. We propose a new entity in angular or interstitial pregnancies called "angular placenta attachment" that could be diagnosed during C-sections or after vaginal delivery without placental separation. Expectant management may be considered for adherent placentas in these cases.
doi:10.1016/j.tjog.2020.09.033 pmid:33218426 fatcat:zexmnswfd5hvvn6egwpctbnosy