Morbidly Adherent Placenta at Extreme Prematurity: Can Major Haemorrhage and Hysterectomy be Prevented?
Authors
Mohamad Nasir Shafiee
Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
Lim Pei Shan
Rahana Abdul Rahman
Nor Azlin Mohamed Ismail
Wan Faraliza Zainal Abidin
Isa Mohd Rose
Mohd Hashim Omar
Abstract
Morbidly adherent placenta with spontaneous rupture of membrane at extreme prematurity poses poor pregnancy outcome. Various issues on different management modalities still remain perplexed and individual consideration is vital. Two cases of morbidly adherent placenta with symptomatic per vaginal bleeding and spontaneous rupture of membrane at severe prematurity were reviewed and discussed. We found that, active intervention by termination of pregnancy and methotrexate therapy at early gestation can prevent the need of hysterectomy following major obstetrics haemorrhage
