Late uterine wedge resection of placenta increta

Background: Recently, preferences for preserving reproductive potential has sparked increasing interest in the conservative management of placenta acc reta, increta, and percreta. Case: a 23-year-old gravida 3 para 2 had a vaginal delivery complicated by retained placenta. The placenta was delivered in multiple fragments followe d by sharp curettage. Her postpartum course was complicated by pelvic pain and menorrhagia, unrelieved by sharp curettage. Four months postpartum, tra nsvaginal ultrasonography and magnetic resonance imaging demonstrated an in tramyometrial mass. Exploratory laparotomy was done with wedge resection of the anterior wall of the uterus under real-time ultrasonographic guidance. Pathologic examination found placenta increta. Conclusion: Conservative management of placenta increta can be used selecti vely to preserve reproductive potential. (Obstet Gynecol 1999;94:823-5. (C) 1999 by The American College of Obstetricians and Gynecologists,).