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Y S Chen, Y Y Zhao, Y Zhang, Y Wang, Y W Zhong, A Q Zhang
Objective: To evaluate the effect of cervical lifting suture in treatment of placenta previa with increta and percreta. Methods: From January 2016 to June 2017, 65 cases (0.78%, 65/8 322) were diagnosed placenta previa with increta and percreta by prenatal ultrasonic score system and confirmed by intraoperative findings in the department of obstetrics and gynecology of Peking University Third Hospital. Totally 62 cases (0.75%, 62/8 322) were included, because 3 cases underwent hysterectomy with placenta in situ...
July 25, 2018: Zhonghua Fu Chan Ke za Zhi
Helena C Bartels, James D Postle, Paul Downey, Donal J Brennan
Background . Placenta accreta spectrum (PAS) is a condition of abnormal placental invasion encompassing placenta accreta, increta, and percreta and is a major cause of severe maternal morbidity and mortality. The diagnosis of a PAS is made on the basis of histopathologic examination and characterised by an absence of decidua and chorionic villi are seen to directly adjacent to myometrial fibres. The underlying molecular biology of PAS is a complex process that requires further research; for ease, we have divided these processes into angiogenesis, proliferation, and inflammation/invasion...
2018: Disease Markers
Shigeki Matsubara
No abstract text is available yet for this article.
July 2018: Geburtshilfe und Frauenheilkunde
Robert A DeSimone, Wendy K Leung, Joseph Schwartz
The increasing incidence of placenta accreta has paralleled the rise in its greatest risk factor: cesarean delivery. In placenta accreta, the abnormal invasion of the chorionic villi into the myometrium prevents separation of the placenta at delivery, and the myometrium is unable to contract to prevent hemorrhage. Spontaneous uterine rupture and hemoperitoneum may also occur in the setting of placenta percreta. The average blood loss during a delivery complicated by placenta accreta is 2 to 5 L, compared to less than 0...
June 27, 2018: Transfusion Medicine Reviews
Jalal A Nanji, Jessica R Ansari, Mary Yurashevich, Johanes M Ismawan, Deirdre J Lyell, Amer K Karam, David M Hovsepian, Edward T Riley
During a cesarean hysterectomy for placenta percreta, transesophageal echocardiography was used to monitor volume status and guide resuscitation. After delivery of the neonate but before massive surgical hemorrhage, a thrombus appeared in the inferior vena cava. Roughly 3 hours later, the patient had hemodynamic changes consistent with an intraoperative pulmonary embolism. Boluses of epinephrine stabilized the patient. An inferior vena cava filter was placed via an in situ internal jugular central venous cannula to prevent further embolic events...
July 16, 2018: A&A practice
Pradip Kumar Saha, Rashmi Bagga, Jasvinder Kaur Kalra, Aashima Arora, Rimpi Singla, Vanita Suri, Kajal Jain, Praveen Kumar, Nalini Gupta, Ashish Jain, Tulika Singh, Ravimohan S Mavuduru
BACKGROUND: Cesarean hysterectomy for adherent placenta is associated with increased maternal morbidity due to massive hemorrhage requiring large volume blood transfusion, bladder or ureteric injury, intensive care unit (ICU) admission and prolonged hospital stay. There is an ongoing effort to improve the outcome of these women and measures to reduce blood loss. OBJECTIVE: The purpose of the present study was to develop an alternate surgical approach for performing a Cesarean hysterectomy in women with adherent placenta in order to reduce hemorrhage and urinary tract injuries, and thereby improve the maternal outcome...
July 4, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Ali Acar, Fedi Ercan, Aybike Pekin, Adeviye Elci Atilgan, H Berkan Sayal, Osman Balci, Hüseyin Gorkemli
OBJECTIVE: To assess the efficacy and safety of a new surgical suture technique for uterine preservation among patients with placental invasion anomalies. METHODS: The present prospective case series included women diagnosed with placental invasion anomalies undergoing cesarean deliveries who desired future fertility at the obstetrics department of a Turkish university hospital between January 10, 2013, and April 20, 2017. Patients were diagnosed with ultrasonography and Doppler ultrasonography; the type of placental invasion anomaly (placenta accreta, increta, or percreta) was confirmed intraoperatively...
July 10, 2018: International Journal of Gynaecology and Obstetrics
Nikolina Docheva, Emily D Slutsky, Nicolette Borella, Renee Mason, James W Van Hook, Sonyoung Seo-Patel
As the rate of cesarean sections continues to rapidly rise, knowledge of diagnosis and management of cesarean scar pregnancies (CSPs) is becoming increasingly more relevant. CSPs rest on the continuum of placental abnormalities which include morbidly adherent placenta (accreta, increta, and percreta). A CSP poses a clinical challenge which may have significant fetal and maternal morbidity. At this point, no clear management guidelines and recommendations exist. Herein we describe the case of a second trimester CSP with rapid diagnosis and management in a tertiary care center...
2018: Case Reports in Obstetrics and Gynecology
Theresa Kuhn, Kristina Martimucci, Abdulla Al-Khan, Robyn Bilinski, Stacy Zamudio, Jesus Alvarez-Perez
Objective  To evaluate if prophylactic hypogastric artery ligation (HAL) decreases surgical blood loss and blood products transfused. Study Design  This is a retrospective cohort study comparing patients with placenta percreta undergoing prophylactic HAL at the time of cesarean hysterectomy versus those who did not. Data were presented as means ± standard deviations, proportions, or medians with interquartile ranges. Demographic and clinical data were compared in the groups using Student's t -test for normally distributed data or the Mann-Whitney U test for nonnormally distributed data...
April 2018: American Journal of Perinatology Reports
Hiroaki Ishida, Akiko Takashima, Masahiro Nagaoka, Naoki Takeshita, Toshihiko Kinoshita
Transverse uterine fundal cesarean section in cases of total placenta previa reduces blood loss, but its influence on subsequent pregnancies, including the uterine rupture risk, remains unclear. We report a case of uterine rupture due to placenta percreta in the first trimester in a 43-year-old woman who underwent transverse uterine fundal incision in a previous pregnancy (at 40 years old). The patient did not undergo assessment of the uterine scare after the previous operation. Oocyte donation and in vitro fertilization at another institution resulted in the current pregnancy...
July 5, 2018: Journal of Obstetrics and Gynaecology Research
Ahmet Rıza Esmer, Reyhan Aslancan, Burak Teymen, Eray Çalışkan
Placenta previa percreta is a serious pregnancy condition that may cause massive bleeding. Life-threatening hemorrhage is commonly managed via cesarean hysterectomy or vascular ligations in order to preserve fertility. We present a case of bilateral external iliac artery thrombosis after pelvic compression and uterine devascularization due to placenta previa percreta. The patient had cesarean section due to ultrasonography and magnetic resonance imaging-diagnosed placenta previa percreta, and stated that she preferred a conservative approach rather than hysterectomy in a case of massive bleeding...
June 2018: Turkish Journal of Obstetrics and Gynecology
Adriana J Wong, Matthew Schlumbrecht, Marilyn Huang
Placenta percreta is increasing in incidence and is associated with the risk of life-threatening haemorrhage. Patients who do not accept blood products present a unique challenge to obstetrician-gynaecologists. In this case report, we present the case of a 42-year-old pregnant Jehovah's Witness with a complete placenta previa and confirmed percreta at 26 weeks' gestation. Due to her religious beliefs against the use of blood products, she was managed with a stepwise surgical approach which involved caesarean delivery with internal iliac (hypogastric) artery ligation, weekly methotrexate and delayed hysterectomy 6 weeks later...
June 11, 2018: BMJ Case Reports
Matalliotakis M, Velegrakis A, Goulielmos Gn, Niraki E, Patelarou Ae, Matalliotakis I
A prior Cesaria section (C-section) is an important risk factor that leads to endometrial damage and abnormal implantation of the placenta. Our retrospective study aims to correlate the frequency of placenta previa to previous C-sections, to determine the effect of male gender in this condition and to evaluate further the maternal outcome. Seventy-six cases with placenta previa were selected out of 5200 live births. Diagnosis was confirmed by ultrasound and in the operating theater. In the 76 women examined, we found 50 cases with a history of a previous C-section (66...
December 2017: Balkan Journal of Medical Genetics: BJMG
Thorsten Braun, Katharina Weizsäcker, Mustafa Zelal Muallem, Janina Tillinger, Larry Hinkson, Frederic Chantraine, Wolfgang Henrich
The number of pregnant women with abnormally invasive placenta (AIP) including clinical relevant placenta increta and percreta has markedly increased with a reported incidence of as high as one in 731, By 2020 in the United States, there will be an estimated 4504 new cases of AIP and 130 AIP-associated maternal deaths annually. The preoperative diagnosis and operative management of AIP is challenging. In a planned cesarean delivery, a vertical lower abdominal skin incision is widely used in order to have enough space to perform a hysterotomy above the cranial edge of the placenta to avoid significant fetal and/or maternal hemorrhage...
June 5, 2018: Journal of Perinatal Medicine
Kui Zeng, Wei Huang, Chao Yu, Rurong Wang
Intraoperative cell salvage (IOCS) for high-risk obstetric hemorrhage is now endorsed by a number of obstetric organizations. Most previous studies have focused on the safety of IOCS from case series and small controlled studies. Here, we describe the effect of IOCS on rates of allogeneic blood transfusion (ABT) under different degrees of bleeding during cesarean section in women with placenta accreta, which has seldom been reported in the literature.We conducted a retrospective analysis on the introduction of routine application of IOCS for the management of hemorrhage during cesarean section in women with placenta accreta...
June 2018: Medicine (Baltimore)
Gabriel Ambrogi, Gilberto Ambrogi, Ailton Augustinho Marchi
Spontaneous uterine rupture in the first trimester of pregnancy is uncommon and difficult to diagnose. Although extremely rare, it is important to consider the occurrence of placenta percreta as differential diagnosis of acute hemorrhagic abdomen at the beginning of pregnancy. We describe below a case of uterine rupture in the first trimester of pregnancy related to placenta percreta.
2018: Case Reports in Obstetrics and Gynecology
Giuseppe Cali, Francesco Forlani, Ilan Timor-Trisch, José Palacios-Jaraquemada, Francesca Foti, Gabriella Minneci, Maria E Flacco, Lamberto Manzoli, Alessandra Familiari, Giorgio Pagani, Giovanni Scambia, Francesco D'Antonio
INTRODUCTION: The aim of this study was to assess the diagnostic accuracy of ultrasound in detecting the depth of abnormally invasive placenta in women at risk. MATERIAL AND METHODS: Prospective longitudinal study including women with placenta previa and at least one prior cesarean delivery or uterine surgery. Depth of abnormally invasive placenta was defined as the degree of trophoblastic invasion through the myometrium and was assessed with histopathological analysis...
May 25, 2018: Acta Obstetricia et Gynecologica Scandinavica
Y Zhao, J W Zhu, D Wu, Q H Wang, S S Lu, X X Liu, L Zou
Objective: To explore the efficacy and safety of uterine lower posterior wall breakwater-like suture technique in controlling the intraoperative bleeding of placenta previa. Methods: From June 2016 to June 2017, 47 patients were diagnosed placenta previa in Union Hospital, Tongji Medical College of Huazhong University of Science and Technology. Posterior wall breakwater-like suture technique was used preferentially, as for cases with poor myometrium layer, lower anterior wall stitch suture was used at the same time...
April 25, 2018: Zhonghua Fu Chan Ke za Zhi
Shannon Armstrong-Kempter, Supuni Kapurubandara, Brian Trudinger, Noel Young, Naim Arrage
Background: The incidence of morbidly adherent placenta, including placenta percreta, has increased significantly over recent years due to rising caesarean section rates. Historically, abnormally invasive placenta has been managed with caesarean hysterectomy; however nonsurgical interventions such as uterine artery embolisation (UAE) are emerging as safe alternative management techniques. UAE can be utilised to decrease placental perfusion and encourage placental resorption, thereby reducing the risk of haemorrhage and other morbidities...
2018: Case Reports in Obstetrics and Gynecology
Louis Marcellin, Pierre Delorme, Marie Pierre Bonnet, Gilles Grange, Gilles Kayem, Vassilis Tsatsaris, François Goffinet
BACKGROUND: Abnormally invasive placentation is the leading cause of obstetric hysterectomy and can cause poor to disastrous maternal outcomes. Most previous studies of peripartum management and maternal morbidity have included variable proportions of severe and less severe cases. OBJECTIVE: The aim of this study was to compare maternal morbidity from placenta percreta and accreta. STUDY DESIGN: This retrospective study at a referral center in Paris includes all women with abnormally invasive placentation from 2003 through 2017...
May 5, 2018: American Journal of Obstetrics and Gynecology
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