Conservative Management of Placenta Previa Percreta in a Jehovah's Witness

Weinstein, Alan G.; Chandra, Pradeep; Schiavello, Henry; Fleischer, Adiel

doi:10.1097/01.aog.0000157762.65732.1b

Cited by 36 publications

(13 citation statements)

References 12 publications

(18 reference statements)

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“…Several small case series suggest that conservative management with uterine preservation is a safe and reasonable option resulting in lower rates of disseminated intravascular coagulation and blood transfusion but higher rates of maternal sepsis. [17][18][19][20][21][22] Strategies include leaving the placenta after caesarean delivery with surgical uterine devascularisation, embolisation of the uterine vessels, uterine compression sutures and/or over sewing of the placental vascular bed. 15,23 Some authors also have advocated the use of methotrexate to inhibit trophoblast growth and hasten postpartum involution of the placenta.…”

Section: Discussionmentioning

confidence: 99%

Optimal management strategies for placenta accreta

Eller

Porter

Soisson

et al. 2009

BJOG

523

277

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Objective To determine which interventions for managing placenta accreta were associated with reduced maternal morbidity.Design Retrospective cohort study.Setting Two tertiary care teaching hospitals in Utah.Population All identified cases of placenta accreta from 1996 to 2008.Methods Cases of placenta accreta were identified using standard ICD-9 codes for placenta accreta, placenta praevia, and caesarean hysterectomy. Medical records were then abstracted for maternal medical history, hospital course, and maternal and neonatal outcomes. Maternal and neonatal complications were compared according to antenatal suspicion of accreta, indications for delivery, preoperative preparation, attempts at placental removal before hysterectomy, and hypogastric artery ligation.Main outcome measures Early morbidity (prolonged maternal intensive care unit admission, large volume of blood transfusion, coagulopathy, ureteral injury, or early re-operation) and late morbidity (intra-abdominal infection, hospital re-admission, or need for delayed re-operation).Results Seventy-six cases of placenta accreta were identified. When accreta was suspected, scheduled caesarean hysterectomy without attempting placental removal was associated with a significantly reduced rate of early morbidity compared with cases in which placental removal was attempted (67 versus 36%, P = 0.038). Women with preoperative bilateral ureteric stents had a lower incidence of early morbidity compared with women without stents (18 versus 55%, P = 0.018). Hypogastric artery ligation did not reduce maternal morbidity.Conclusions Scheduled caesarean hysterectomy with preoperative ureteric stent placement and avoiding attempted placental removal are associated with reduced maternal morbidity in women with suspected placenta accreta.

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Section: Discussionmentioning

confidence: 99%

Optimal management strategies for placenta accreta

Eller

Porter

Soisson

et al. 2009

BJOG

523

277

View full text Add to dashboard Cite

show abstract

“…L'embolisation des artères utérines a également été décrite pour tenter de réduire le risque hémorragique en cas de traitement conservateur [27,28]. Son utilisation pour traiter une hémorragie du post-partum est largement démontrée [29][30][31].…”

Section: Discussionunclassified

Comparaison historique de deux types de prises en charge de placenta accreta: radicale versus conservatrice

Kayem¹,

Anselem²,

Schmitz

et al. 2007

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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“…L'embolisation des artères utérines a été décrite pour tenter de réduire le risque hémorragique en cas de traitement conservateur [44,45]. Son utilisation pour traiter une hémorragie du post-partum est largement démontrée [46][47][48].…”

Section: Traitement Adjuvant En Cas De Prise En Charge Conservatriceunclassified