Retrospective multicenter study of leaving the placenta in situ for patients with placenta previa on a cesarean scar

Miyakoshi, Kei; Otani, Toshiro; Kondoh, Eiji; Makino, Shintaro; Tanaka, Mamoru; Takeda, Satoru

doi:10.1002/ijgo.12397

Cited by 19 publications

(19 citation statements)

References 29 publications

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“…However, an experienced acoucher should be able to diagnose the vast majority of AIP cases clinically at laparotomy (See point 14) and subsequent histopathological findings from cases of 'failed' expectant management suggest that the risk of misdiagnosis is very low. For this case series, 37 Another smaller study of 36 women managed conservatively reported a success rate of 69% 38 (level 2b evidence). Three reviews of published case series report success rates of 85% 39 , 58% 40 and 60% 41 .…”

Section: Accepted Manuscriptmentioning

confidence: 81%

Evidence-based guidelines for the management of abnormally invasive placenta: recommendations from the International Society for Abnormally Invasive Placenta

Collins

Alemdar

Beekhuizen

et al. 2019

American Journal of Obstetrics and Gynecology

245

228

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Section: Accepted Manuscriptmentioning

confidence: 81%

Evidence-based guidelines for the management of abnormally invasive placenta: recommendations from the International Society for Abnormally Invasive Placenta

Collins

Alemdar

Beekhuizen

et al. 2019

American Journal of Obstetrics and Gynecology

245

228

View full text Add to dashboard Cite

show abstract

“…Another smaller study of 36 women managed conservatively reported a success rate of 69% 38 (level 2b evidence). Three reviews of published case series report success rates of 85% 39 , 58% 40 and 60% 41 .…”

Section: Is Expectant Management Of Clinically Confirmed Aip Effective and Does It Reduce Maternal Morbidity When Compared To Surgical Trmentioning

confidence: 99%

Evidence-based Guidelines for the Management of Abnormally Invasive Placenta: Recommendations From the International Society for Abnormally Invasive Placenta

Collins¹,

Alemdar²,

Beekhuizen³

et al. 2020

Obstetric Anesthesia Digest

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“…Numerous studies [11,12] showed that conservative approach (with or without partial resection of placenta) was a uterus-preserving option for patient with PAS disorders. Nevertheless PAS disorders managed with the placenta left in situ require close follow-up monitor and it takes at least several months after delivery before placental resorption was achieved [13]. Moreover maternal morbidity and mortality is not rare in the placenta left in situ approach [14].…”

Section: Discussionmentioning

confidence: 99%

Pregnancy outcomes in patients with placenta previa on a cesarean scar

Guo¹,

Shan²,

Xu³

et al. 2019

Preprint

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OBJECTIVE: We aimed to examine the clinical features and pregnancy outcomes in patients with placenta previa on a cesarean scar. METHODS: A retrospective review of women who were diagnosed with placenta previa on a cesarean scar in the First Bethune Hospital of Jilin University between December 2011 and December 2017 was performed. Basic patient characteristics and pregnancy outcomes data were collected. Characteristics that are associated with maternal morbidities (post-partum hemorrhage ≥ 2000 ml and nits transfused >4) and adverse neonatal outcomes (5-minute Apgar <7 and Low-birth-weight infant) were evaluated. RESULT ： A total of 183 patients was identified. PAS disorders were observed in 63 cases(34.4%).The median postpartum hemorrhage was 700 ml (range,100-7900).70 patients (38.2%) had a blood loss ≥ 2000 mL.43 subjects(23.4%) required >4 units of blood. The median 1-minute Apgar score and 5-minute Apgar score was 9 and 9.2 respectively. Additionally ， median neonatal birth weight was 1880g (range, 700-4260). Patients with comorbid PAS disorders are more likely subject to post-partum hemorrhage and require units transfused (>4) (p <0.05). Similarly, patients with major placenta praevia had a higher incidence of post-partum hemorrhage and units transfused (>4) than patients with minor placenta praevia (p <0.05). Patients who undertook emergency cesarean due to hemorrhage were more likely to have a low-birth-weight infant than women who undertook planned cesarean. CONCLUSION: PPP is associated with considerable maternal and fetal morbidity, particularly in patients with comorbid PAS disorders. Delayed delivery may be warranted for those without meaningful vaginal bleeding and preterm labor but need further prospective clinical trials to confirm.

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Retrospective multicenter study of leaving the placenta in situ for patients with placenta previa on a cesarean scar

Abstract: Leaving the placenta in situ, with close postpartum follow-up for at least several months, could be a uterus-preserving option for patient with PAS disorders.

Cited by 19 publications

References 29 publications

Evidence-based guidelines for the management of abnormally invasive placenta: recommendations from the International Society for Abnormally Invasive Placenta

Evidence-based guidelines for the management of abnormally invasive placenta: recommendations from the International Society for Abnormally Invasive Placenta

Evidence-based Guidelines for the Management of Abnormally Invasive Placenta: Recommendations From the International Society for Abnormally Invasive Placenta

Pregnancy outcomes in patients with placenta previa on a cesarean scar

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