The antenatal diagnosis of placenta accreta

Comstock, C. H.; Bronsteen, Richard

doi:10.1111/1471-0528.12557

Cited by 151 publications

(119 citation statements)

References 55 publications

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“…Cali et al 32 and Comstock et al 33,34 showed that firsttrimester scans of patients who had second-and thirdtrimester morbidly adherent placentas, which were retrospectively examined, there were sonographic findings consistent with early accreta (also known as a "scar pregnancy"). We reported on a collaborative study in which 10 patients with diagnoses of cesarean scar pregnancies opted to continue the pregnancies.…”

Section: Discussionmentioning

confidence: 99%

Cesarean Scar Pregnancies

Timor‐Tritsch

Khatib

Monteagudo

et al. 2015

J of Ultrasound Medicine

123

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Objectives To evaluate the management, clinical courses, and outcomes of cesarean scar pregnancies diagnosed in the first trimester. Methods We identified 60 cases of cesarean scar pregnancies diagnosed between 5 and 14 weeks. Group A contained 48 patients with fetal/embryonic cardiac activity; group B comprised 12 patients without cardiac activity; and group C included 11 patients with cardiac activity who chose expectant management. Results Five of the 48 patients (10.4%) in group A were successfully treated for vaginal bleeding. Thirty‐three (68.7%) received methotrexate injections, and all had full resolution. Three (6.3%) required uterine artery embolization for late‐developing arteriovenous malformations. Ten of the 12 patients (83.3%) in group B were managed expectantly and had full recovery. Two of the 10 (20.0%) had arteriovenous malformations; 1 had unsuccessful uterine artery embolization followed by a hysterectomy, and the second requested a hysterectomy. Ten of the 11 patients (90.9%) in group C continued the pregnancies. One declined local injection. Four of the 10 (40.0%) delivered live offspring by successive elective cesarean deliveries. Three (30.0%) had hysterectomies for placenta percreta, and 1 did not have a hysterectomy after delivery. Five (50%) had second‐trimester complications, all leading to hysterectomies. Of the 60 patients, 20 (33.3%) had serious complications: 5 had arteriovenous malformations; 4 had uterine artery embolization; and 11 had hysterectomies. Conclusions A cesarean scar pregnancy is a serious complication for patients who have had cesarean deliveries. Counseling, treatment, and follow‐up are challenging for patients and caregivers. However, emerging data from different management approaches confirm that a cesarean scar pregnancy may progress and result in a live neonate at the expense of further fertility. This study confirmed that expectant management of a cesarean scar pregnancy is associated with a high risk of hysterectomy due to morbidly adherent placenta.

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Section: Discussionmentioning

confidence: 99%

Cesarean Scar Pregnancies

Timor‐Tritsch

Khatib

Monteagudo

et al. 2015

J of Ultrasound Medicine

123

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“…Invazyvios placentos sukelto kraujavimo valdymas yra labai sudė-tingas, todėl ankstyva ir išsami antenatalinė diagnostika yra ypač svarbi [5]. Siekiant įvertinti placentos invazijos gylį, aplinkinių struktūrų įtraukimą į patologinį procesą, dažniausiai atliekami ultragarsinis (UG) ir magnetinio rezonanso tyrimai (MRT) [6].…”

Section: įVadasunclassified

Preokliuzinių balionėlių naudojimas perioperaciniam kraujavimui mažinti esant invazyviai placentai: tretinio lygio stacionaro patirtis ir literatūros apžvalga

Morozovaitė¹,

Šiaudinytė²,

Volochovič³

et al. 2017

LietChirur

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Įvadas / tikslasNenormalus choriono gaurelių skverbimasis ir placentos prisitvirtinimas vadinamas invazyvia placenta. Pavojingiausias šios patologijos variantas yra peraugusi placenta. Viena sunkiausių peraugusios placentos komplikacijų yra masyvus kraujavimas. Vienas galimų būdų sumažinti netekto kraujo kiekį operacijos metu yra preokliuzinių balionėlių išpūtimas gimdą maitinančiose kraujagyslėse. Straipsnio tikslas -aptarti preokliuzinių balionėlių naudojimą pacientėms, kurioms antenataliniu laikotarpiu diagnozuota peraugusi placenta, palyginti kraujavimo profilaktikos taktiką ir pateikti literatūros apžvalgą. Tyrimo medžiaga ir metodai Atlikta retrospektyvioji dviejų pacienčių medicininės dokumentacijos analizė, palyginti taikytos intervencinės radiologijos metodikos ypatumai bei pateikta literatūros apžvalga. 205Preokliuzinių balionėlių naudojimas perioperaciniam kraujavimui mažinti esant invazyviai placentai: tretinio lygio stacionaro patirtis ir literatūros apžvalga RezultataiAntenataliniu laikotarpiu diagnozavus invazyvią placentą, nutarta pacientėms prieš suplanuotas cezario pjūvio operacijas masyvaus kraujavimo profilaktikai išpūsti į gimdą maitinančias kraujagysles įstumtus preokliuzinius balionėlius iškart po naujagimio gimimo. Pirmuoju atveju balionėliai išleisti tik perkėlus pacientę į skyrių. Praėjus 4 valandoms po operacijos dėl vidinio kraujavimo buvo atlikta relaparatomija, revizuotos kraujagyslių bigės, papildoma perrišta kairė vidinė klubinė arterija. Antruoju atveju balionėliai išleisti ir ištraukti prieš užbaigiant cezario pjūvio operaciją, dar kartą patikrinta hemostazė. Išvados Peraugusi placenta yra grėsminga akušerinė patologija, galinti sukelti masyvų kraujavimą. Pacienčių gydymas turi būti iš anksto atsakingai planuojamas. Intervencinės radiologijos metodai padeda sumažinti netekto kraujo kiekį. Norint užtikrinti adekvačią hemostazę, preokliuzinius balionėlius reikėtų išleisti prieš baigiant operaciją. Reikšminiai žodžiai: invazyvi placenta, kraujavimas akušerijos praktikoje, intervencinė radiologija, preokliuziniai balionėliai Background / ObjectiveAbnormal penetration of chorionic villi into the wall of uterus is called invasive placenta. The most dangerous type is placenta percreta. It can lead to massive bleeding, which is one of the most serious complications. In order to reduce blood loss during operation intraoperative balloon occlusion of uterus supplying vessels could be use. Our aim is to present the management of perioperative balloon occlusion for two patients with antenatal diagnosis of placenta percreta, compare the prophylaxis of bleeding and review literature. Patients and MethodsWe carried out a retrospective analysis of medical history of two patients, compared interventional radiology methods between these cases and performed a literature review. ResultsTwo patients with antenatal diagnosis of placenta percreta were determined to undergo an elective cesarean section. Preoperative balloon insertion and inflation after birth was used for massive bleeding prophylaxis. I...

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“…However, invasion of adjacent organs could be evaluated better with MRI than ultrasound. Therefore, MRI is frequently used as an adjunct in diagnosis when the ultrasound findings are suspicious or placenta previa implants on posterior or lateral uterine wall [13]. Bailit et al [14] reviewed a cohort of 115502 women and their neonates born in 25 hospitals in the United States.…”

Section: J Clin Exp Invest Wwwjceionlineorg Vol 7 No 1 March 2016mentioning

confidence: 99%

A Single Center Experience on the Management of Placental Invasion Abnormalities

Ekin

Biler²,

Gezer³

et al. 2016

J Clin Exp Invest

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Objective: The aim of this study is to investigate our management of placental invasion abnormalities. Methods:A retrospective study was conducted on patients admitted to a tertiary referral center with a diagnosis of placental invasion abnormalities between 2011 and 2015. Risk factors and perinatal outcomes associated with placental invasion abnormalities were identified. Results:The overall incidence of placental invasion abnormalities during the 5-year period was 8.3/10000 deliveries, which showed an increasing trend. Ultrasonography and magnetic resonance imaging correctly identified placental invasion abnormality in 36.7% and 68.7% cases, respectively. Majority of patients (55.1%) with adherent placenta were diagnosed at the time of delivery. Of these patients, 22.4% underwent hysterectomy, 83.8% required at least one of the additional surgical procedures and 55% were transfused at least four units of packed red blood cell. Conclusion:Since placental invasion abnormalities are associated with significant morbidity, delivery should be scheduled in a tertiary center with appropriate expertise and facilities.

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The antenatal diagnosis of placenta accreta

Cited by 151 publications

References 55 publications

Cesarean Scar Pregnancies

Cesarean Scar Pregnancies

Preokliuzinių balionėlių naudojimas perioperaciniam kraujavimui mažinti esant invazyviai placentai: tretinio lygio stacionaro patirtis ir literatūros apžvalga

A Single Center Experience on the Management of Placental Invasion Abnormalities

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