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Title: Placenta Accreta in a Woman with Childhood Uterine Irradiation: A Case Report and Literature Review
Authors: Sasagasako, Nanayo
Tani, Hirohiko
Chigusa, Yoshitsugu
Io, Shingo
Mogami, Haruta
Hamanishi, Junzo  kyouindb  KAKEN_id
Horie, Akihito
Kondoh, Eiji  kyouindb  KAKEN_id  orcid (unconfirmed)
Sato, Yukiyasu
Mandai, Masaki
Author's alias: 最上, 晴太
濵西, 潤三
堀江, 昭史
近藤, 英治
万代, 昌紀
Issue Date: 2019
Publisher: Hindawi Limited
Journal title: Case reports in obstetrics and gynecology
Volume: 2019
Thesis number: 2452975
Abstract: The pregnancies of childhood cancer survivors who have received uterine irradiation are associated with a high risk of several obstetrical complications, including placenta accreta. The present case was a 26-year-old pregnant woman with a history of myelodysplastic syndrome treated with umbilical cord blood transplantation following chemotherapy and total body irradiation at the age of 10. Despite every possible measure to prevent preterm labor, uterine contractions became uncontrollable and a female infant weighing 892 g was vaginally delivered at 27⁺⁴ weeks of gestation. Under the postpartum ultrasonographic diagnosis of placenta accreta, we selected to leave the placenta in situ. Although emergency bilateral uterine artery embolization was required, complete resorption of the residual placenta was accomplished on the 115th day postpartum. Our experience highlighted the following points. (1) The expectant management of placenta accreta arising in an irradiated uterus may not only fulfill fertility preservation, but may also reduce possible risks associated with cesarean hysterectomy. (2) Due to extreme thinning of and a poor blood supply to the myometrium, reaching an antepartum diagnosis of placenta accreta in an irradiated uterus is difficult. (3) The recurrence of placenta accreta in subsequent pregnancies needs to be considered after successful preservation of the uterus.
Rights: Copyright © 2019 Nanayo Sasagasako et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI(Published Version): 10.1155/2019/2452975
PubMed ID: 31781442
Appears in Collections:Journal Articles

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