Discussion

Pregnancies have been reported after much lower pelvic radiotherapy of between 10 and 21 Gy, with pregnancy complications of miscarriage, pre-term labour and low birth weight (Slanina et al. 1985; Kalapurakal et al. 2004; Chiarelli et al. 2000; Critchley and Wallace 2005).

We suggest that at the doses received by our patient (36 Gy to the right hemipelvis), her endometrium was damaged at least partially, which could be the reason for the morbidly adherent placenta on the right. Morbid adherence of the placenta is a known risk in pregnancy after transcervical resection of the endometrium (Hamar et al. 2006; Hare and Olah 2005). As assisted conception techniques improve and with the availability of donor eggs (if not previously stored from the patient prior to radiotherapy) becoming more available, women who previously could not hope for a pregnancy now have this possibility.