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  • Title: Conservative management of a near-term cervico-isthmic pregnancy, followed by a successful subsequent pregnancy: a case report.
    Author: Kayem G, Deis S, Estrade S, Haddad B.
    Journal: Fertil Steril; 2008 Jun; 89(6):1826.e13-5. PubMed ID: 17714710.
    Abstract:
    OBJECTIVE: To describe a rare case of a cervico-isthmic pregnancy with anterior placenta percreta that was treated at 34 weeks of gestation by removing the placenta and the attached uterine wall in one piece. DESIGN: Case report. SETTING: Tertiary university hospital. PATIENT(S): A 32-year-old woman was diagnosed with a cervico-isthmic pregnancy and an anterior placenta percreta at 34 weeks' gestation at delivery by a cesarean section. INTERVENTION(S): Delivery of the neonate was performed by a uterine incision beyond the limits of the placenta. Thereafter, the placenta and the attached uterine wall were removed step by step by ligature section. MAIN OUTCOME MEASURE(S): Intraprocedural or postprocedural complications and fertility preservation. RESULT(S): The delivery was successfully performed without intraprocedural or postprocedural complications and with preservation of the patient's fertility. A successful pregnancy was conducted 1 year later. CONCLUSION(S): In case of cervico-isthmic pregnancy with anterior placenta percreta, resection in one block of the placenta and the attached uterine wall may be an option for preserving fertility.
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