Conservative management of adherent retained placenta: report of 4 cases

The frequency of adherent placenta is increasing due to growing number of caesarean deliveries. The optimal management of this condition remains unclear, resulting in complications in the peripartum period such as severe haemorrhage, a possible need for caesarean hysterectomy, and even severe injuries to pelvic organs. We report cases of conservative management of adherent retained placenta following midtrimester abortion, preterm normal and caesarean delivery. All were managed conservatively with antibiotics, and followed up with 2-4 weekly USG. There was complete resorption of placenta by 3-6 months postpartum in all the cases. No complications developed during the conservative management and all women resumed normal menstruation by 5-6 months post procedure. Conservative management of abnormally invasive placentation can be effective and fertility can be preserved which should be considered in highly selective cases. Further research with prospective evaluation for conservative treatments versus different approaches for adherent retained placenta is necessary.