Hemorrhagic morbidity in placenta accreta spectrum with and without placenta previa

Mulla, Bethany M.; Weatherford, Robert; Redhunt, Allyson M; Modest, Anna M.; Hacker, Michele R.; Hecht, Jonathan L.; Spiel, Melissa; Shainker, Scott A.

doi:10.1007/s00404-019-05338-y

Cited by 29 publications

(36 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The difference in clinical outcomes in this study are likely a reflection of a lower incidences of placenta previa and deeper placental pathology (increta/percreta) in the IVF group; these are likely not mutually exclusive and both are known risk factors for increased morbidity. 8,18,19 There is a paucity of data to provide guidance on the second question; however, we believe this work does provide some insight. In delving into the pathophysiology, albeit with small numbers and not statistically significant, we were intrigued to find a higher prevalence of diminished ovarian reserve and ovulatory dysfunction among IVF pregnancies with PAS compared with those without.…”

Section: Discussionmentioning

confidence: 91%

Placenta Accreta Spectrum: In Vitro Fertilization and Non-In Vitro Fertilization and Placenta Accreta Spectrum in a Massachusetts Cohort

et al. 2020

Self Cite

View full text Add to dashboard Cite

Objective The incidence of placenta accreta spectrum (PAS) has been increasing in the United States. In addition, there has also been an increase in the utilization of in vitro fertilization (IVF). The IVF pregnancies confer an increased risk of adverse obstetric and neonatal outcomes, but there is limited data on whether IVF is associated with PAS. The aim of this study is to assess the association between IVF and the risk of PAS. Study Design This was a retrospective cohort study of deliveries from January 1, 2013 to August 1, 2018 at a tertiary hospital in the Massachusetts. IVF pregnancies were compared with non-IVF pregnancies, and PAS diagnosis was confirmed by histopathology reports. Hospital administrative data and medical record review were used, and supplemented with data from birth certificates from the Massachusetts Department of Public Health. Results We identified 28,344 pregnancies that met inclusion criteria, of which 1,418 (5.0%) were IVF pregnancies. The overall incidence of PAS was 0.4% (2.2% in the IVF group and 0.3% in the non-IVF group). Women who underwent IVF had 5.5 times the risk of PAS (95% confidence interval [CI]: 3.4–8.7) compared with women in the non-IVF group, adjusted for maternal age, nulliparity, and year of delivery (Table 5). Compared with women in the non-IVF group, the IVF group had fewer prior cesarean deliveries (22.6 vs. 64.2%) and a lower prevalence of placenta previa (19.4 vs. 44.4%). Conclusion Women with an IVF pregnancy carry an increased risk of PAS compared with non-IVF. Among women who underwent IVF, there was a lower prevalence of prior cesarean deliveries and placenta previa. Future work is needed to identify the mechanism of association for this increased risk as well as a reliable tool for antenatal detection in this cohort of women. Key Points

show abstract

Section: Discussionmentioning

confidence: 91%

Placenta Accreta Spectrum: In Vitro Fertilization and Non-In Vitro Fertilization and Placenta Accreta Spectrum in a Massachusetts Cohort

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…In recent years, due to increases in the caesarean section rate and uterine cavity operation rate, the incidence of PAS has increased, and the incidence of related postpartum haemorrhage has also increased [6]. Uncontrollable postpartum haemorrhage can occur when PAS is present in combination with placenta previa [7][8][9]. Caesarean section is the main treatment method for PAS, and haemorrhage control during the operation is key for successful treatment.…”

Section: Introductionmentioning

confidence: 99%

The application of prophylactic balloon occlusion of the internal iliac artery for the treatment of placenta accreta spectrum with placenta previa: a retrospective case-control study

Peng

Jiang

Cheng

et al. 2020

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background: Severe obstetric haemorrhage caused by placenta accreta spectrum (PAS) results in significant maternal morbidity and mortality. The effectiveness of prophylactic balloon occlusion of the internal iliac artery in PAS patients remains controversial. Therefore, we conducted a retrospective case-control study to investigate the clinical effectiveness of this treatment. Methods: The clinical data of 104 patients with PAS complicated with placenta previa who delivered by caesarean section between January 2016 and January 2019 were collected, and the patients were divided into two groups. The study group (48 cases) underwent internal iliac artery preset balloon occlusion before caesarean section and uterine artery embolisation according to the bleeding status after surgery, while the control group (56 cases) did not undergo internal iliac artery preset balloon occlusion before caesarean section. Results: The operation and hospitalisation times in the study group were longer than those in the control group. Additionally, the hysterectomy rate in the study group was significantly higher than that in the control group. No significant differences in blood loss, blood transfusion volume, urinary system injury, postoperative ICU transfer rate, or neonatal scores were identified between the groups. Among the patients without invasive placenta (placenta increta and percreta), blood loss was lower in the study group, and the caesarean hysterectomy rate did not significantly differ between the groups. Among the patients with invasive placenta, blood loss and the caesarean hysterectomy rate did not significantly differ between the groups. The risk of hysterectomy in the study group was related to invasive placenta penetration, a large area of placental invasion, or abnormal vascular filling. One patient in the study group had a thrombus in the left lower extremity artery.

show abstract

“…Prenatal diagnosis has been shown to reduce the associated morbidity, particularly caused by peripartal haemorrhage [ 11 ]. However, the prepartum diagnosis of placenta accreta in ultrasound is still limited compared to placenta increta or percreta [ 12 ], and in individual cases, devastating bleeding occurs when a regular attempt is made to remove unknown PAS in the absence of risk factors [ 13 ]. Optimal conditions for delivery in PAS have been described, including thorough prenatal consultation and management by experienced multidisciplinary teams in large perinatal centres [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Placenta accreta spectrum disorders—experience of management in a German tertiary perinatal centre

Bluth

Schindelhauer

Nitzsche

et al. 2020

Arch Gynecol Obstet

View full text Add to dashboard Cite

Purpose Placenta accreta spectrum (PAS) disorders can cause major intrapartum haemorrhage. The optimal management approach is not yet defined. We analysed available cases from a tertiary perinatal centre to compare the outcome of different individual management strategies. Methods A monocentric retrospective analysis was performed in patients with clinically confirmed diagnosis of PAS between 07/2012 and 12/2019. Electronic patient and ultrasound databases were examined for perinatal findings, peripartum morbidity including blood loss and management approaches such as (1) vaginal delivery and curettage, (2) caesarean section with placental removal versus left in situ and (3) planned, immediate or delayed hysterectomy. Results 46 cases were identified with an incidence of 2.49 per 1000 births. Median diagnosis of placenta accreta (56%), increta (39%) or percreta (4%) was made in 35 weeks of gestation. Prenatal detection rate was 33% for all cases and 78% for placenta increta. 33% showed an association with placenta praevia, 41% with previous caesarean section and 52% with previous curettage. Caesarean section rate was 65% and hysterectomy rate 39%. In 9% of the cases, the placenta primarily remained in situ. 54% of patients required blood transfusion. Blood loss did not differ between cases with versus without prenatal diagnosis (p = 0.327). In known cases, an attempt to remove the placenta did not show impact on blood loss (p = 0.417). Conclusion PAS should be managed in an optimal setting and with a well-coordinated team. Experience with different approaches should be proven in prospective multicentre studies to prepare recommendations for expected and unexpected need for management.

show abstract

Hemorrhagic morbidity in placenta accreta spectrum with and without placenta previa

Cited by 29 publications

References 15 publications

Placenta Accreta Spectrum: In Vitro Fertilization and Non-In Vitro Fertilization and Placenta Accreta Spectrum in a Massachusetts Cohort

Placenta Accreta Spectrum: In Vitro Fertilization and Non-In Vitro Fertilization and Placenta Accreta Spectrum in a Massachusetts Cohort

The application of prophylactic balloon occlusion of the internal iliac artery for the treatment of placenta accreta spectrum with placenta previa: a retrospective case-control study

Placenta accreta spectrum disorders—experience of management in a German tertiary perinatal centre

Contact Info

Product

Resources

About