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Placenta accreta

Ricardo Mauricio Malagón Reyes, Rubén Castorena de Ávila, María de Jesús Ángeles Vázquez, César Augusto Núñez Monteagudo, Hugo Mendieta Zerón
OBJECTIVE: Placenta accreta is one of the main obstetrical complications worldwide. The aim of this study was to report the experience of managing placenta accreta with a 6% polidocanol solution sclerotherapy. MATERIALS AND METHODS: We selected patients between 37 weeks of gestation and 38 weeks of gestation, diagnosed with placenta accreta, treated at the Maternal Perinatal Hospital "Monica Pretelini Sáenz", Toluca, Mexico, during the period from November 2013 to August 2014...
October 2016: Taiwanese Journal of Obstetrics & Gynecology
Shigeki Matsubara
Conservative management (leaving the placenta in situ) for abnormally invasive placenta (AIP: accreta, increta, percreta) has been repeatedly discussed in AOGS (1, 2). Delayed hemorrhage and infection are important adverse events. Especially, delayed hemorrhage required hysterectomy 3-9 months post-cesarean section in 22-58% of cases (1, 3), often performed as an emergency surgery (1, 3). Although delayed hysterectomy is not always associated with massive bleeding, a magnetic resonance imaging (MRI) showed marked gadolinium enhancement (marked blood flow) in the placental-bed-myometrium on post-cesarean day 34 (4), suggesting that hemorrhage may be serious during delayed hysterectomy at least up to one month post-cesarean...
October 14, 2016: Acta Obstetricia et Gynecologica Scandinavica
Grace Lim, Jeanne M Horowitz, Senta Berggruen, Linda M Ernst, Rebecca L Linn, Bradley Hewlett, Jennifer Kim, Laurie A Chalifoux, Robert J McCarthy
STUDY OBJECTIVE AND DESIGN: To evaluate the hypothesis that assigning grades to magnetic resonance imaging (MRI) findings of suspected placenta accreta will correlate with hemorrhagic outcomes. We chose a single-center, retrospective, observational design. SETTING, PATIENTS, AND MEASUREMENTS: Nulliparous or multiparous women who had antenatal placental MRI performed at a tertiary level academic hospital were included. Cases with antenatal placental MRI were included and compared with cases without MRI performed...
November 2016: Journal of Clinical Anesthesia
Raphael Câmara, Marcelo Burlá, José Ferrari, Lana Lima, Joffre Amim, Antonio Braga, Jorge Rezende
Cesarean section by maternal request is the one performed on a pregnant woman without medical indication and without contraindication to vaginal delivery. There is great controversy over requested cesarean section. Potential risks include complications in subsequent pregnancies, such as uterine rupture, placenta previa and accreta. Potential benefits of requested cesareans include a lower risk of postpartum hemorrhage in the first cesarean and fewer surgical complications compared with vaginal delivery. Cesarean section by request should never be performed before 39 weeks...
July 2016: Revista do Colégio Brasileiro de Cirurgiões
S H Cui, Y X Zhi, K Zhang, L D Zhang, L N Shen, Y N Gao
Objective: To investigate the value of temporary balloon occlusion of the abdominal aorta in the treatment of complete placenta previa with placenta accreta. Methods: From January 2015 to February 2016, 24 cases of complete placenta previa with placenta accreta were treated with temporary balloon occlusion of the abdominal aorta(the study group)before cesarean, and 24 cases of complete placenta previa with placenta accreta did not receive balloon occlusion(the control group). The operation time, intraoperative blood loss, intraoperative blood transfusion volume, the perioperative hemoglobin level, the hysterectomy rate and the related complications were compared retrospectively...
September 25, 2016: Zhonghua Fu Chan Ke za Zhi
Jae-Seong Lee, Gi-Youn Hong, Byung-Joon Park, Hyejin Hwang, Rayon Kim, Tae-Eung Kim
We present a case of retained placenta accreta treated by high-intensity focused ultrasound (HIFU) ablation followed by hysteroscopic resection. The patient was diagnosed as submucosal myoma based on ultrasonography in local clinic. Pathologic examination of several pieces of tumor mass from the hysteroscopic procedure revealed necrotic chorionic villi with calcification. HIFU was performed using an ultrasound-guided HIFU tumor therapeutic system. The ultrasound machine had been used for real-time monitoring of the HIFU procedure...
September 2016: Obstetrics & Gynecology Science
M Okumura, R P Francisco, M M Kondo, R Schultz, M Zugaib
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
Jovana Lekovich, Joshua Stewart, Sarah Anderson, Erin Niemasik, Nigel Pereira, Stephen Chasen
OBJECTIVE: Müllerian anomalies are associated with increased risk of miscarriage, intrauterine growth restriction (IUGR) and preterm birth. While a commonly implicated cause is restricted expansion of endometrial cavity, alternatively it could be due to abnormal placentation. We sought to examine clinical and histopathologic factors associated with preterm delivery in women with Müllerian anomalies. STUDY DESIGN: One hundred and eleven singleton pregnancies in 85 women were analyzed retrospectively...
August 17, 2016: Journal of Perinatal Medicine
Zhenyu Chen, Ju Li, Jian Shen, Jiaxi Jin, Wei Zhang, Wan Zhong
OBJECTIVE: To evaluate direct puncture embolization of the internal iliac artery with hemostatic gelatin sponge particles to treat pernicious placenta previa coexisting with placenta accreta during cesarean delivery. METHODS: A retrospective study was conducted of data from women with pernicious placenta previa and placenta accreta who underwent direct puncture embolization of the internal iliac artery during cesarean delivery at a center in China between September 1, 2013, and February 28, 2015...
August 21, 2016: International Journal of Gynaecology and Obstetrics
Yan-Li Wang, Xu-Hua Duan, Xin-Wei Han, Ling Wang, Xian-Lan Zhao, Zhi-Min Chen, Qin-Jun Chu, Wei Zhang
BACKGROUND: To compare the efficacy of temporary abdominal aortic occlusion with internal iliac artery occlusion for the management of placenta accreta. PATIENTS AND METHODS: 105 patients with placenta accreta were selected for treatment with temporary abdominal aortic occlusion (n = 57, group A) or bilateral iliac artery occlusion (n = 48, group B). Temporary abdominal aortic and internal iliac artery balloon occlusions were performed during caesarean sections...
September 6, 2016: VASA. Zeitschrift Für Gefässkrankheiten
A Le Gouez, F J Mercier
Major obstetric hemorrhage is a challenge for anesthesiologists because it remains responsible for over 10% of maternal deaths in high-income countries. A standardized multidisciplinary management, described in locally validated protocols and based on international guidelines is mandatory to prevent these deaths. The first difficulty relies on the systematic underestimation of the bleeding. Collection bags must be used to facilitate the diagnosis and therefore rapid management. The etiologies in antenatal or postpartum must be well-known in order to be treated adequately...
August 31, 2016: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
André Campos da Cunha, Rosilene da Silveira Betat, Thaís Kappel Vieira Dal Pai, Camila Pauluci Arcolini, Amanda Muriela Gobatto, Anna Manoela de Holleben Bicca, Paulo Ricardo Gazzola Zen, Rafael Fabiano Machado Rosa
No abstract text is available yet for this article.
August 2016: Taiwanese Journal of Obstetrics & Gynecology
Élise Thellier, Dan Benhamou
Caesarean delivery was performed in 20% of all deliveries in France in 2010 and this rate has remained unchanged during the last 10 years. Indications to perform this procedure are well defined, especially in case of scarred uterus, twin pregnancies, macrosomia or breech presentation. Surgical (haemorrhage, urinary or intestinal tract injury) and anaesthetic (hypotension after regional anaesthesia, difficult intubation and aspiration after general anaesthesia) complications may occur during the procedure. Complications may also be encountered in the early postoperative period (haemorrhage, infection, venous thromboembolism) but also on the long-term, such as placenta accreta or uterine rupture which may significantly impact obstetric outcomes...
June 2016: La Revue du Praticien
A Dimirov, T Garnizov, V Zlatkov, B Frundeva, A Masseva
Conservative management of placenta accrete consists in leaving the entire placenta accreta in situ after vaginal delivery of the fetus. This behavior requires active monitoring the vital signs of mother, genital status and paraclinical indicators for an extended period after birth. Monitoring is suspended after full absorption of the placenta. The success of the conservative approach depends on: the adopted protocol formanagement of placenta accreta, whether the diagnosis is known before birth, the possible of application techniques, reducing blood flow to the uterus, keeping the placental period and others...
2016: Akusherstvo i Ginekologii︠a︡
Y L Tan, H Suharjono, N L J Lau, H Y Voon
BACKGROUND: The contemporary obstetrician is increasingly put to the test by rising numbers of pregnancies with morbidly adherent placenta. This study illustrates our experience with prophylactic bilateral internal iliac artery occlusion as part of its management. METHODS: Between January 2011 to January 2014, 13 consecutive patients received the intervention prior to scheduled caesarean delivery for placenta accreta. All cases were diagnosed by ultrasonography, color Doppler imaging and supplemented with MRI where necessary...
June 2016: Medical Journal of Malaysia
Kerry L O'Brien, Lynne Uhl
Obstetric hemorrhage remains a leading cause of maternal mortality with more than 140,000 deaths annually worldwide. Abnormal placentation has increased to become the most common diagnosis requiring massive blood transfusion in obstetrics, with uterine atony a close second. At our institution, as well as nationwide, there has been a steady increase in pregnancies complicated by abnormal placentation, including accreta, increta, and percreta. Providers at our facility created the New England Center for Placental Disorders in May 2015 to address these complex patients...
September 2016: Transfusion
Eric Jauniaux, Sally L Collins, Davor Jurkovic, Graham J Burton
OBJECTIVE: Determining the depth of villous invasiveness before delivery is pivotal in planning individual management of placenta accreta (PA). We have evaluate the value of the various ultrasound signs described in the literature for the diagnosis of PA and in the assessment of the depth of villous invasiveness. DATA SOURCES: We undertook a PubMed and MEDLINE search of the relevant studies published between the first prenatal ultrasound description of PA in 1982 and 30 March 2016 using key words "placenta accreta", "placenta increta", "placenta percreta", "abnormally invasive placenta", "morbidly adherent placenta" and "placenta adhesive disorder" as related to "sonography", "ultrasound diagnosis", "prenatal diagnosis", "grey-scale imaging", three-dimensional (3D) ultrasound and "colour Doppler imaging"...
July 26, 2016: American Journal of Obstetrics and Gynecology
Lea Azour, Cecilia Besa, Sara Lewis, Amita Kamath, Edward R Oliver, Bachir Taouli
Appropriate placentation is critical to maternal and fetal outcomes. Abnormal placentation, including placenta previa and morbidly adherent placenta, is increasing in incidence and is associated with multiple risk factors including advanced maternal age and history of prior cesarean delivery. Magnetic resonance imaging (MRI) is increasingly used in assessing the type and extent of abnormal placentation, often leading to modifications in surgical approach. Here, we review the MRI features and appropriate reporting of placenta previa and the placenta accreta spectrum...
July 29, 2016: Abdominal Radiology
B Lyu, M Chen, X X Liu
OBJECTIVE: To investigate the risk factors of peripartum hysterectomy in placenta previa through retrospective study of 3 840 placenta previa cases. METHODS: The clinical data of 3 840 patients with placenta previa who delivered in West China Second University Hospital between Jan 2005 and June 2014 were analyzed retrospectively. The relationship of certain factors and peripartum hysterectomy was analyzed, including maternal age, residence place, parity, prior curettage, prior cesarean section, twin or multiple pregnancy, antenatal vaginal bleeding, type of placenta previa, suspected placenta accreta, antenatal level of hemoglobin and gestational age at delivery...
July 25, 2016: Zhonghua Fu Chan Ke za Zhi
Yasutaka Konishi, Satoshi Yamamoto, Kei Sugiki, Hidetoshi Sakamoto, Shigehito Sawamura
Cesarean deliveries in patients with placenta accreta often are accompanied by life-threatening bleeding and sometimes death. A novel, multidisciplinary approach that uses uterine embolization after cesarean delivery recently has been advocated; however, embolization in the radiology department requires transfer of postoperative patients, which could increase maternal mortality and morbidity. In a case of severe placenta accreta, we planned a stepwise treatment, including cesarean delivery without separation of the placenta followed by intraoperative uterine arterial embolization in a hybrid operating room, followed by hysterectomy a few weeks after cesarean delivery...
September 15, 2016: A & A Case Reports
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