Placenta Percreta in First Trimester after Multiple Rounds of Failed Medical Management for a Missed Abortion
Table 1
Morbidly adherent placentas (MAPs) diagnosed in the first trimester and treated before 15 weeks’ gestation [1, 3, 4].
Author and year
Type of MAP
Prior CS§
Prior D&C†
GA at Diagnosis#
Presenting symptoms
US diagnostic of MAP
Management & outcome
Helkjaer et al., 1982
n/
1
0
11 wks
VB
n/a
Laparotomy, repair
Woolcott et al., 1987
Percreta
2
0
10 wks
VB
No; missed abortion
Laparotomy, hysterectomy + bladder repair
Haider, 1990
Percreta
1
0
10 wks
VB
No; missed abortion
Laparotomy, hysterectomy
Ecker et al., 1992
Increta
n/a
n/a
1st trimester
n/a
n/a
Laparotomy, hysterectomy
Arredondo et al., 1995
Accreta
0
3
1st trimester
None
No; missed abortion
Laparotomy, hysterectomy
Gherman et al., 1999
Increta
1
1
8 wks
VB/abd pain
Yes; suspected MAP
Laparoscopy/laparotomy, hysterectomy
Walter et al., 1999
Increta
1
0
11 wks
VB
n/a
D&C/laparotomy, hysterectomy
Marcus et al., 1999
Percreta
2
0
13 wks
VB
n/a
UAE/D&C/laparotomy, hysterectomy
Chanrachakul et al., 2001
Increta
1
0
7 wks
VB
No; missed abortion
D&C/laparotomy, hysterectomy
Hopker et al., 2002
Percreta
1
1
10 wks
Abd pain
Yes; suspected MAP versus invasive mole
Laparotomy, hysterectomy
Shih et al., 2002
Accreta
0
0
8 wks
VB
Yes; suspected MAP
Elective laparotomy at 15 wks, hysterectomy
Buetow, 2002
Percreta
1
0
1st trimester
VB/pelvic pain
Yes; suspected MAP
Laparotomy, hysterectomy
Chen et al., 2002
Accreta
2
1
9 wks
VB
Yes; suspected MAP
Laparotomy, hysterectomy
Liang et al., 2003
Percreta
2
n/a
1st trimester
Abd pain/shock
n/a
Laparotomy, hysterectomy
Liu et al., 2003
Increta
1
0
1st trimester
n/a
n/a
UAE/laparotomy, hysterectomy
Coniglio and Dickinson, 2004
Accreta
2
0
8 wks
Abd pain/shock
Yes; suspected Cesarean scar pregnancy
Laparotomy, repair
Dabulis and McGuirk, 2007
Percreta
3
1
9 wks
Abd pain
Yes; suspected MAP
Laparotomy, hysterectomy
Son et al., 2007
Increta
0
3
8 wks
Abd pain/syncope
Abd/pelvis computed tomography
Laparotomy, hysterectomy
Tanyi et al., 2008
Percreta
1
1
7 wks
VB/abd pain
No; threatened abortion
D&C/laparotomy, hysterectomy
Papadaskis et al., 2008††
Percreta
2
1
11 wks
VB
No; missed abortion
D&C/laparotomy, hysterectomy
Soleymani et al., 2009
Increta
0
0
11 wks
VB
Yes; suspected MAP
D&C/UAE, resolved
Yang et al., 2009
Increta
2
3
12 wks
VB
Yes; suspected MAP
UAE, resolved
Pont et al., 2010
Percreta
1
1
13 wks
Abd pain
n/a
Laparotomy, hysterectomy
Hanif et al., 2011
Percreta
2
2
12 wks
Abd pain/syncope
No; ectopic pregnancy
Laparotomy, hysterectomy
Shojai et al., 2012††
Increta
2
0
7 wks
n/a
No; missed abortion
D&C/laparotomy, hysterectomy
Shaamash et al., 2014
Accreta
2
0
11 wks
VB/abd pain
Yes; suspected MAP versus molar changes
D&C/laparotomy, hysterectomy
Cesarean delivery; †dilation and curettage; vaginal bleeding; uterine artery embolization; #gestational age; unknown or not reported; ††failed medical management with misoprostol.
