Abnormal Placental Invasion—a Novel Approach to Treatment

Ophir, Ella; Singer-Jordan, Jonathan; Odeh, Marwan; Hirch, Yael; Maksimovsky, Olga; Shaider, Oleg; Yvry, Simon; Solt, Ido; Bornstein, Jacob

doi:10.1097/ogx.0b013e3181c46913

Cited by 13 publications

(11 citation statements)

References 98 publications

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“…Preoperative placement of a catheter in the internal iliac or uterine arteries, with or without balloon inflation at the time of delivery, or embolization after cesarean section can be performed 39,43. Higher failure of embolization in placenta accreta was observed when compared with its use for postpartum hemorrhage due to other causes, like uterine atony or retained products of gestation.…”

Section: Obstetric Management Strategiesmentioning

confidence: 99%

The sonographic appearance and obstetric management of placenta accreta

Cheung¹,

Chan²

2012

IJWH

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Placenta accreta is a condition of abnormal placental implantation in which the placental tissue invades beyond the decidua basalis. It may invade into or even through the myometrium and adjacent organs, such as the urinary bladder. The incidence has been rising in recent years. It is one of the important obstetric complications nowadays, leading to significant maternal morbidity and mortality. In the past, this condition was often diagnosed at the time of delivery when massive and unexpected hemorrhage occurred. Hysterectomy, associated with significant physical and psychological consequences, was usually the only management option. As more obstetricians have become aware of this condition, early identification with antenatal imaging diagnostic technology has become possible. Ultrasound scan plays an important role in the antenatal diagnosis. Various sonographic features with different specificity and sensitivity have been described in the literature. In equivocal cases, magnetic resonance imaging may be helpful. With such information, more accurate counseling can be offered to the mothers and their families before delivery. The delivery can also be arranged at a favorable time and in an institution where multidisciplinary support is available. Input from a hematologist, interventional radiologist, intensive care physician, urology surgeon, and/or other specialist are desirable. Apart from hysterectomy, various forms of conservative management can also be considered when the diagnosis is made prior to delivery. Fertility can therefore be preserved. After delivery, with or without hysterectomy performed, psychological support to the mothers and their families is essential.

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Section: Obstetric Management Strategiesmentioning

confidence: 99%

The sonographic appearance and obstetric management of placenta accreta

Cheung¹,

Chan²

2012

IJWH

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“…In placenta accreta the placental villi adhere to the underlying uterine myometrium without an intervening layer of decidua 1 . Although the exact etiology is unknown, the leading theory postulates that defects or prior damage to the endometrial decidua basilis layer result in defective cell signaling and excessive trophoblast proliferation and invasion 2 . Additional theories include intrinsic trophoblast cell defects and defective cytotrophoblast cell signaling secondary to differences in oxygen tension in areas of uterine scarring 2 .…”

mentioning

confidence: 99%

“…Although the exact etiology is unknown, the leading theory postulates that defects or prior damage to the endometrial decidua basilis layer result in defective cell signaling and excessive trophoblast proliferation and invasion 2 . Additional theories include intrinsic trophoblast cell defects and defective cytotrophoblast cell signaling secondary to differences in oxygen tension in areas of uterine scarring 2 . Placenta accreta ranges in severity from mild forms, which are only visible microscopically, to severe, grossly apparent forms where invasion extends into adjacent organs.…”

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confidence: 99%

Transfusion requirements in obstetric patients with placenta accreta

et al. 2011

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“…The addition of gadolinium-based contrast agents may improve the specificity of MRI, but this is generally considered controversial in pregnancy because of its unknown effects on the fetus. 20 The material crosses the placenta and is excreted via the fetal kidneys into amniotic fluid. It is a pregnancy class C drug and the American College of Radiology recommends that IV gadolinium should be avoided in pregnancy unless the potential benefit justifies the potential risk to the fetus.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Placenta Accreta: A Review of the Etiology, Diagnosis, and Management

Žalud¹,

Goh²

2016

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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The incidence of placenta accreta is rising, primarily due to the increase in cesarean section rates. The prenatal diagnosis of placenta accretas has been shown to decrease the amount of blood loss and complications. Real-time ultrasound is helpful for diagnosing placenta accreta, and magnetic resonance imaging (MRI) can increase the sensitivity of prenatal diagnosis. Postpartum hysterectomy for placenta accreta has been the standard of therapy for placenta accreta, but conservative management including uterine artery embolization, and leaving the placenta in situ may be considered in patients who want to preserve their fertility. The etiology of placenta accreta is due to a deficiency of maternal decidua, resulting in placenta invasion into the uterine myometrium. The molecular basis is yet to be elucidated, but it probably involves abnormal paracrine or autocrine signaling between the deficient maternal decidua and the invading placenta trophoblastic tissue.

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Abnormal Placental Invasion—a Novel Approach to Treatment

Cited by 13 publications

References 98 publications

The sonographic appearance and obstetric management of placenta accreta

The sonographic appearance and obstetric management of placenta accreta

Transfusion requirements in obstetric patients with placenta accreta

Placenta Accreta: A Review of the Etiology, Diagnosis, and Management

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