Conservative management of a near-term cervico-isthmic pregnancy, followed by a successful subsequent pregnancy: a case report

Fertil Steril. 2008 Jun;89(6):1826.e13-5. doi: 10.1016/j.fertnstert.2007.06.007. Epub 2007 Aug 21.

Abstract

Objective: To describe a rare case of a cervico-isthmic pregnancy with anterior placenta percreta that was treated at 34 weeks of gestation by removing the placenta and the attached uterine wall in one piece.

Design: Case report.

Setting: Tertiary university hospital.

Patient(s): A 32-year-old woman was diagnosed with a cervico-isthmic pregnancy and an anterior placenta percreta at 34 weeks' gestation at delivery by a cesarean section.

Intervention(s): Delivery of the neonate was performed by a uterine incision beyond the limits of the placenta. Thereafter, the placenta and the attached uterine wall were removed step by step by ligature section.

Main outcome measure(s): Intraprocedural or postprocedural complications and fertility preservation.

Result(s): The delivery was successfully performed without intraprocedural or postprocedural complications and with preservation of the patient's fertility. A successful pregnancy was conducted 1 year later.

Conclusion(s): In case of cervico-isthmic pregnancy with anterior placenta percreta, resection in one block of the placenta and the attached uterine wall may be an option for preserving fertility.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Apgar Score
  • Cervix Uteri / pathology
  • Female
  • Fertility
  • Humans
  • Infant, Newborn
  • Placenta / surgery
  • Pregnancy
  • Pregnancy Complications / pathology
  • Pregnancy Complications / surgery*
  • Urinary Bladder / pathology