Minilaparotomy hysterectomy through ≤5 cm Pfannenstiel incision provides an appealing, effective, expeditious, minimal access and less invasive cost-effective option/alternative to the traditional abdominal approach obviating the need for any additional expensive equipment and, above all, improves upon the perioperative outcome, notwithstanding, whatsoever, on the quality of surgery.

IntroductionOne of the ensuing complications of placenta accreta includes loss of fertility.Case presentationAn Asian origin Indian national patient with history of placenta accreta at the time of previous delivery and had conservative management with injection methotrexate after the failure of surgical intervention, conceives again and has uneventful antenatal period and parturition.ConclusionConservative strategy of leaving the excessively adherent placenta in-situ alongwith adjuvant therapy in the form of injection methotrexate, not only prevents dreadful complications but also retains fertility in haemodynamically stable patients desirous of future pregnancy.

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