Planned conservative management of placenta accreta – experience of a regional general hospital

Lo, Tsz Kin; Yung, Wai Kuen; Lau, Wai Lam; Law, Bassanio; Lau, Stephanie H. Y.; Leung, WC

doi:10.3109/14767058.2013.818118

Cited by 19 publications

(12 citation statements)

References 16 publications

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“…This created a heavy burden on the public obstetric services and increased the risk of adverse pregnancy outcomes. [9][10][11][12] Case Comments…”

Section: Discussionmentioning

confidence: 99%

“…There has been growing evidence on leaving placental tissue behind for conservative management. According to our unit's experience published recently as a case series, 9 planned conservative management of placenta accreta is feasible with good outcome. Prerequisite of success includes careful preoperative planning, involvement of experienced personnel from different disciplines, and a highly dedicated team for postpartum follow-up.…”

Section: Major Placenta Praevia/accreta-compromised Carementioning

confidence: 99%

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Social obstetrics: non-local expectant mothers admitted through accident and emergency department in a public hospital in Hong Kong

et al. 2014

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Objectives: To review the pregnancy outcomes of non-booked, non-local pregnant women delivering in Kwong Wah Hospital via admission to the Accident and Emergency Department 1 year after the announcement by the Hospital Authority to stop antenatal booking for non-eligible persons; and to perform a literature review of local studies about non-eligible person deliveries over the last decade. Design: Case series.Setting: A public hospital in Hong Kong. Participants:All women who held the People's Republic of China passport or the two-way permit and those non-eligible persons whose spouses were Hong Kong Identity Card holders, who delivered in Kwong Wah Hospital from 1 April 2011 to 31 March 2012.Results: Overall, 219 women who were non-eligible persons delivered 221 live births during the study period. Compared with the annual statistics of Kwong Wah Hospital in 2011, non-local mothers were of higher parity; more likely to have hypertensive disease (including pre-eclamptic toxaemia), preterm deliveries (ie at <37 weeks), babies needing admission to the special care baby unit, and macrosomic babies (ie weighing >4.0 kg). The rates of induction of labour and caesarean section were lower in this group. There was no significant difference in the maternal and neonatal outcomes between women who had no booking and those who had a booking in another Hospital Authority or private hospital. There were Social obstetrics: non-local expectant mothers admitted through accident and emergency department in a public hospital in Hong Kong IntroductionThe influx of expectant mothers from Mainland China leading to overwhelming of the local obstetric and neonatal services has been a hot topic of discussion in the media in the past few years. In New knowledge added by this study • Non-eligible person (NEP) delivery in Hong Kong has been a social obstetric phenomenon specific to this region (Hong Kong SAR) because of political circumstances. Despite the reduction in the quantity, these nonbooked deliveries continue to run a high risk of adverse obstetric outcomes due to difficulties experienced by the expectant mothers in accessing a well-structured obstetric service. Implications for clinical practice or policy • Regardless of the number of patient load, the NEP women remain potentially at risk of obstetric complications.Health care professionals should be prepared for managing the near-miss conditions.

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“…This created a heavy burden on the public obstetric services and increased the risk of adverse pregnancy outcomes. [9][10][11][12] Case Comments…”

Section: Discussionmentioning

confidence: 99%

Section: Major Placenta Praevia/accreta-compromised Carementioning

confidence: 99%

Social obstetrics: non-local expectant mothers admitted through accident and emergency department in a public hospital in Hong Kong

et al. 2014

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“…Indeed, false positive results can occur in 18 -28%. 8,22,23) Moreover, if placenta accreta is successfully managed conservatively, the patient remains hemodynamically stable because of a remarkable reduction in blood loss. Therefore, in our institution, cesarean section is currently performed under spinal anesthesia, and is converted to general anesthesia, if necessary.…”

Section: Anesthetic Techniquementioning

confidence: 99%

“…Prophylactic embolization and placement of balloon occlusion catheter Amsalem et al 29) and Lo et al 22) reported that the mean blood loss was 900-1,600 ml in planned conservative management with adjuvant prophylactic uterine artery embolization shortly after cesarean section and that no peripartum hysterectomy was needed in either series. In contrast, Soyer et al 30) performed pelvic embolization in emergency cases alone.…”

Section: Controversial Issuesmentioning

confidence: 99%

Optimal strategies for conservative management of placenta accreta: a review of the literature

Kondoh

Kawasaki

Chigusa

et al. 2015

Hypertens Res Pregnancy

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“…We reported recently one of the largest case series of placenta accreta that were managed successfully by planned placental conservation 1 . All were typical cases with placenta previa and a history of Cesarean delivery.…”

mentioning

confidence: 99%

Scalloping of placenta–myometrium interface on ultrasound in case with myomectomy scar

Lam

Cheung

et al. 2016

Ultrasound in Obstet & Gyne

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Planned conservative management of placenta accreta – experience of a regional general hospital

Abstract: Successful planned conservative management of placenta accreta is feasible in the setting of district general hospital with facilities for interventional radiology.

Cited by 19 publications

References 16 publications

Social obstetrics: non-local expectant mothers admitted through accident and emergency department in a public hospital in Hong Kong

Social obstetrics: non-local expectant mothers admitted through accident and emergency department in a public hospital in Hong Kong

Optimal strategies for conservative management of placenta accreta: a review of the literature

Scalloping of placenta–myometrium interface on ultrasound in case with myomectomy scar

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