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Human placental lactogen and color Doppler in predicting expulsion of retained adherent placenta: a new clinical observation

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Abstract

Purpose

To present a new clinical observation made in three cases of retained adherent placenta, a rare obstetrical complication, associated with potentially life-threatening hemorrhage.

Methods

Three consecutive cases of retained adherent placenta are presented.

Results

Diagnosis of placenta increta in two and placenta percreta in one case was established with ultrasound and MRI. Methotrexate 50 mg i.v. (300 mg total dose) and follinic acid 0.1 mg/kg were administered on alternating days, over 12 days. On follow-up, placental perfusion on color Doppler was present up to the point when circulating hPL levels were no longer detectable; this was followed in all cases by spontaneous placental expulsion within 10 days.

Conclusions

The observation that both color Doppler and human placental lactogen can be used to monitor response to therapy and predict placental expulsion should be evaluated in future cases of retained adherent placenta.

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Fig. 1
Fig. 2

Abbreviations

FFP:

Fresh frozen plasma

MRI:

Magnetic resonance imaging

LMW:

Low molecular weight

β-hCG:

Beta subunit of human chorionic gonadotropin

hPL:

Human placental lactogen

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Conflict of interest statement

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. 1st Department for Obstetrics and Gynecology, Papageorgiou Hospital, Aristotle University of Thessaloniki, Ring Road of Thessaloniki, N. Efkarpia, 56403, Thessaloniki, Greece

    L. Zepiridis, M. Zafrakas, T. D. Theodoridis, E. Assimakopoulos, P. Tzevelekis, D. Athanatos, J. N. Bontis & B. C. Tarlatzis

Authors
  1. L. Zepiridis
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  2. M. Zafrakas
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  3. T. D. Theodoridis
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  4. E. Assimakopoulos
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  5. P. Tzevelekis
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  6. D. Athanatos
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  7. J. N. Bontis
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  8. B. C. Tarlatzis
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Corresponding author

Correspondence to L. Zepiridis.

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Zepiridis, L., Zafrakas, M., Theodoridis, T.D. et al. Human placental lactogen and color Doppler in predicting expulsion of retained adherent placenta: a new clinical observation. Arch Gynecol Obstet 280, 1041–1044 (2009). https://doi.org/10.1007/s00404-009-1045-9

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  • DOI: https://doi.org/10.1007/s00404-009-1045-9

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