Nese HİLALİ, Adnan INCEBİYİK, Aysun CAMUZCUOGLU, Mehmet VURAL, Sezen KOCARSLAN, Ekrem KARAKAŞ, Hasan Husnu YUCE, Hakan CAMUZCUOGLU

İki adet morbid yapışık plasentalı olguda konservatif tedavi

Plasenta perkratada konservatif tedavi uygulanan iki olgu sunuldu. Kliniğimizde plasenta perkrata tanısı konan iki olguya konservatif tedavi uygulandı. İlk olguda kanamadan dolayı tedavide istenilen başarı elde edilemedi. İkinci olguda; abdominal orta hat ve uterin fundusda klasik insizyon, internal iliak arter ligasyonu, profilaktik geniş spektrumlu antibiyotik kullanımı, menstruel siklus supresyonu, human koryonik gonadotropin seviyesinde hızlı düşüş trendi elde edene kadar metotreksat uygulaması ve plasental atılım gerçekleşene kadar hastanın haftalık izlemi ile başarılı bir sonuç elde edildi. Hemodinamik olarak stabil ve fertilite isteği olan plasenta perkrata olgularında konservatif yaklaşım daha uygun bir seçenek olabilir.

Anahtar Kelimeler:

Placenta percreta, methotrexate, conservative, ligation

Conservative management of two cases of morbidly adherent placenta

To present two cases of placenta percreta which were treated with conservative management in our clinic. Two cases of retained placenta percreta are presented. Treatment was failed in the first case because of haemorrhage. The second one was treated successfully with the procedures which consisted of caesarean section with midline abdominal and classic incision in the uterine fundus, internal iliac artery ligation, prophylactic broad-spectrum antibiotic treatment, suppression of menstrual cycle, use of methotrexate until the achievement of rapid downtrend of human chorionic gonadotropin, and monitoring the patient until spontan expulsion or resorbtion of placenta. It may be better to treat the cases of placenta percreta with conservative management, if the patients are hemodynamically stable and desirable for future fertility.

Keywords:

Placenta percreta, methotrexate, conservative, ligation,

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