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Pregnancy complicated by morbidly adherent placenta in a patient with bilateral ovarian agenesis: a case report

Authors Wong HS

Received 27 August 2012

Accepted for publication 25 September 2012

Published 5 February 2013 Volume 2013:5 Pages 53—55


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

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Hong Soo Wong

Australian Women's Ultrasound Centre, Brisbane, Australia

Abstract: The author presents a case of in vitro fertilization pregnancy complicated by morbidly adherent placenta in a patient with congenital bilateral ovarian agenesis. A 31-year-old woman with congenital bilateral ovarian agenesis who had undergone two previous dilatation and curettage procedures conceived following in vitro fertilization with a donor egg. Spontaneous labor occurred at 38 weeks and 5 days' gestation. The labor was augmented in the active phase and resulted in instrumental vaginal delivery. The third stage was complicated by hemorrhage and retained placenta. Morbidly adherent placenta was diagnosed on attempt at manual removal of the placenta, and the adherent part of the placenta was left in situ. This was removed uneventfully at 5 weeks following childbirth when there was no blood flow observed between the placenta and the myometrium on Doppler ultrasound examination. In conclusion, successful parturition is possible in patients with congenital bilateral ovarian agenesis. When morbidly adherent placenta is managed conservatively, the placenta may be safely removed if there is no vascularity between the placenta and the myometrium.

Keywords: IVF, placenta accreta, parturition, myometrium

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