Conservative management of placenta percreta

Matsuzaki, Shinya; Yoshino, Kiyoshi; Endo, Masayuki; Kakigano, Aiko; Takiuchi, Tsuyoshi; Kimura, Tadashi

doi:10.1002/ijgo.12411

Cited by 62 publications

(61 citation statements)

References 17 publications

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“…24 PAS is rare but results in high maternal morbidity and mortality rates. 16,25,26 Various factors such as placenta previa, previous CD, and IVF have been recognized as risk factors for PAS, but the role of previous UAE as a risk factor was not well understood. [27][28][29] Here, we identified previous UAE as a clear risk factor for PAS in the subsequent pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…We excluded articles written in languages other than in English and those published before 2002, with some modification of the method previously described. [16][17][18] In addition, we excluded all articles related to UAE for uterine fibroids, cervical pregnancy, cesarean scar pregnancy, or uterine arteriovenous malformations. For our search, we used the following specific keywords for each database: "uterine artery embolization", "subsequent pregnancy", "uterine artery embolization" and "placenta accreta.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

<p>Obstetric Outcomes of Pregnancy After Uterine Artery Embolization</p>

Jitsumori¹,

Endo²,

Hara³

et al. 2020

IJWH

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Background: Uterine artery embolization (UAE) is used to treat severe postpartum hemorrhage (PPH). According to a few studies, UAE for PPH was associated with preterm birth, fetal growth restriction (FGR), and placenta accreta spectrum (PAS) in subsequent pregnancies. These previous studies, however, lacked controls, and to the best of our knowledge, no systematic literature reviews have been conducted thus far. We report the results of our retrospective case-control study of pregnancies after UAE at a single center and include a literature review to evaluate the risk of PAS in pregnancies after UAE. Methods: We retrospectively reviewed data from deliveries at our hospital between January 2012 and October 2017. We divided the delivery data into cases with previous UAEs performed for PPH (the post-UAE group) and those without UAEs (the non-UAE group, which included women without previous PPH). We defined PAS as cases in which hysterectomy was performed and pathological examination confirmed the diagnosis. Results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs). Results: We used data from 3155 patients in this study, of whom 16 patients had undergone UAE (post-UAE group) and 3139 had not (non-UAE group). We found no differences between the groups in terms of frequency of preterm births (12.5% versus 14.2%, respectively; OR, 0.863; 95% CI, 0.218 to 3.414; P = 0.84) or FGR (6.2% versus 10.0%, respectively; OR, 0.602; 95% CI, 0.104 to 3.584; P = 0.61). However, cases of PAS were significantly more common in the post-UAE group (37.5%) than in the non-UAE group (1.2%; OR, 50.303; 95% CI, 17.38 to 145.592; P < 0.01). Conclusion: Our results suggest that previous UAE is a significant risk factor for PAS.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

<p>Obstetric Outcomes of Pregnancy After Uterine Artery Embolization</p>

Jitsumori¹,

Endo²,

Hara³

et al. 2020

IJWH

Self Cite

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show abstract

“…Conservative management might involve serious complications, such as post-partum hemorrhage and infection, which could require second embolization or unplanned hysterectomy. These serious complications were reported in 56% of patients on conservative management, including 22% of emergency hysterectomy cases in a recent literature [10].…”

Section: Discussionmentioning

confidence: 96%

“…Alternatively, uterine conservative management combined with endovascular embolization may be considered [10]. Indeed, we initially planned for preservation management if case 3 has extreme adhesion or invasion, but was not performed eventually.…”

Section: Discussionmentioning

confidence: 99%

Cesarean hysterectomy in a hybrid operating room for placenta percreta: a report of three cases

et al. 2019

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Background: Placenta percreta is the most severe abnormality in invasive placenta and often treated with cesarean hysterectomy. Endovascular embolization for placental abnormality is known to reduce bleeding from the placental bed and from the abnormal neovasculature surrounding the uterus. We describe three cases of placenta percreta treated with uninterrupted cesarean hysterectomy and embolization performed using a hybrid operating room (HOR). Case description: Cases were two placenta previa percretas and an impending uterine rupture with placenta percreta, treated with elective cesarean hysterectomy in HOR. Planned conversion of spinal to general anesthesia was performed after the fetal delivery. Immediate embolic devascularization of abnormal neovasculature was directly observed and facilitated adhesiolysis. Surgical blood losses were 1850 g, 2500 g, and 1180 g, respectively. Conclusion: Cesarean hysterectomy combined with endovascular embolization in the HOR for placenta percreta is an advantageous option to enhance patient safety by multidisciplinary approach without patient transfer.

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“…This systematic review followed the PRISMA guidelines [32]. Two investigators (SM and YN) independently performed the study selection (screening of titles, abstracts and full texts of relevant articles), as previously described [33].…”

Section: Article Retrievalmentioning

confidence: 99%

Significance of Malignant Peritoneal Cytology on the Survival of Women with Early-Stage Cervical Cancer: A Japanese Gynecologic Oncology Group Study

Matsuo

Shimada

Matsuzaki

et al. 2019

JCM

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This study examined the association between peritoneal cytology and survival in early-stage cervical cancer. This is a nationwide multicenter retrospective study, examining consecutive women with clinical stage IB1-IIB cervical cancer who underwent radical hysterectomy with available peritoneal cytology results from 2004–2008. Propensity score inverse probability of treatment weighting was used to assess the impact of malignant peritoneal cytology on survival. Among 1409 analyzed cases, 88 (6.2%) had malignant peritoneal cytology. On weighted models, malignant peritoneal cytology was associated with decreased disease-free survival (hazard ratio (HR) 1.78, 95% confidence interval (CI) 1.36–2.32) and overall survival (OS, HR 1.93, 95% CI 1.44–2.59). On sensitivity analyses, malignant peritoneal cytology was associated with decreased OS in adenocarcinoma/adenosquamous carcinoma, high-risk early-stage disease and those who received concurrent chemo-radiotherapy. However, among women who received postoperative systemic chemotherapy, malignant peritoneal cytology was not associated with OS (HR 1.21, 95% CI 0.72–2.04). A systematic review, including our results, showed that malignant peritoneal cytology was associated with decreased OS (HR 4.03, 95% CI 1.81–8.99) and increased recurrence in squamous carcinoma (odds ratio 1.89, 95% CI 1.05–3.39) and adenocarcinoma (odds ratio 4.30, 95% CI 2.30–8.02). In conclusion, the presence of malignant cells in peritoneal cytology is associated with decreased survival in early-stage cervical cancer. The possible benefit of systemic chemotherapy in this subgroup merits further investigation.

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Conservative management of placenta percreta

Abstract: The present systematic review revealed high maternal morbidity during conservative management of placenta percreta.

Cited by 62 publications

References 17 publications

<p>Obstetric Outcomes of Pregnancy After Uterine Artery Embolization</p>

<p>Obstetric Outcomes of Pregnancy After Uterine Artery Embolization</p>

Cesarean hysterectomy in a hybrid operating room for placenta percreta: a report of three cases

Significance of Malignant Peritoneal Cytology on the Survival of Women with Early-Stage Cervical Cancer: A Japanese Gynecologic Oncology Group Study

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