A modified suture technique for the treatment of patients with pernicious placenta previa and placenta accreta spectrum: a case series

Abstract

Background: Pernicious placenta previa complicated by placenta accreta spectrum (PAS) often leads to hysterectomy or even maternal death due to massive bleeding. In recent years, the application of balloons has received increasing attention. It is easier to use and has reasonably good effect. However, for some patients, especially those who still have some placental residue, there might still be active bleeding. To solve this problem, we propose a method of pressure sutures around the balloon to provide a better hemostasis effect.Methods: An observational study was conducted on patients with pernicious placenta previa and PAS at the

Overexpressed LAMC2 promotes trophoblast over‐invasion through the PI3K/Akt/MMP2/9 pathway in placenta accreta spectrum

“…PAS has been reported to occur in up to 50% of women with pernicious placenta previa, which is by far the highest risk group for obstetric delivery complications. 3,4 Notwithstanding the fact that the most common risk factors associated with PAS are previous cesarean delivery and placenta previa, there are still a proportion of patients of these subjects without PAS. 22 Accordingly, we speculated in addition to risk factors, elements related to trophoblast growth, angiogenesis and invasion play essential roles in the pathogenesis of PAS.…”

“…1,2 Among them, pregnant women with both PAS and pernicious placenta previa, a type of placenta previa attached to a previous cesarean scar, are now the cohort of obstetric patients at greatest risk for delivery complications. 3,4 Over the past decades, the incidence of PAS has increased dramatically with a growing rate of cesarean sections and the reported prevalence of PAS in China is 2.2%, higher than in other countries. 5 PAS have emerged as an ongoing major iatrogenic public health challenge in the 21st century.…”

“…Placenta accreta spectrum (PAS), encompassing placenta accreta, increta, and percreta, is a devastating obstetric complication that can lead to massive hemorrhage, related organ damage, cesarean hysterectomy, and the need for intensive care resources 1,2 . Among them, pregnant women with both PAS and pernicious placenta previa, a type of placenta previa attached to a previous cesarean scar, are now the cohort of obstetric patients at greatest risk for delivery complications 3,4 . Over the past decades, the incidence of PAS has increased dramatically with a growing rate of cesarean sections and the reported prevalence of PAS in China is 2.2%, higher than in other countries 5 .…”

Enhancing postpartum hemorrhage prediction in pernicious placenta previa: a comparative study of magnetic resonance imaging and ultrasound nomogram

“…All patients were suspected of having PPP due to routine ultrasound examination during pregnancy and received MRI scoring of PPP in the second trimester and ultrasound examination and scoring before delivery. The exclusion criteria were ( Chattopadhyay et al, 1993 ): gestational age of delivery < 28 weeks; ( Zhu et al, 2021 ): non-delivery in our hospital ( Jiang et al, 2019 ); multiple pregnancies ( Chen et al, 2016 ); vaginal delivery ( Yu et al, 2016 ); perioperative procedures that significantly affect blood loss, such as abdominal aortic balloon occlusion and total hysterectomy; and ( Hou et al, 2020 ) the evidence of other hemorrhage factors, such as coagulopathy and uterine contraction weakness, among others. Figure 1 shows the flow chart of patient selection criteria.…”

Expression of ADAM17 and its clinical value for patients with pernicious placenta previa: A retrospective study of 148 PPP patients underwent cesarean section

“…[2] During the early pregnancy, the endometrial stroma undergoes decidualization under the effect of ovarian hormones, and villi are implanted into the decidualized endometrium or decidua, forming the uterine placental blood circulation. [3] If the decidua of the uterus is primary dysplasia or damaged, the decidua at the bottom or the decidua sponge layer is reduced or absent, resulting in the chorion directly attached to the myometrium of the uterus. [4] Pregnancy combined with PPP is likely to lead to premature delivery, DIC, hemorrhagic shock, placental abruption.…”