Single dose methotrexate in successful evacuation of second trimester placenta accreta

Abstract

Morbidly adherent placenta is a serious and life-threatening condition. High index of suspicion for placenta accreta can save patient from undergoing hysterectomy. Timely and appropriate treatment modality is key in reducing morbidity of the patient Reporting herewith a case of 22-24 weeks intrauterine fetal demise in a primigravida patient who was diagnosed with Placenta accreta. Ultrasonography and MRI confirmed the diagnosis. Primigravida with no live issue, no active bleeding and stable vital parameters favored the option of conservative management in the form of “single dose methotrexate regime”. Patient was then given Injection methotrexate 50 mg IM on day 1. Regularly monitored with CBC(complete blood count),LFT(Liver Function Test),KFT(kidney Function Test), beta HCG, USG and pelvic doppler. On day 7 piecemeal removal of complete placenta accrete was successful under USG guidance.