Approaches to reduce urinary tract injury during management of placenta accreta, increta, and percreta: a systematic review

Tam, Kiran B. Tam; Dozier, James; Martin, James N.

doi:10.3109/14767058.2011.576720

Cited by 76 publications

(53 citation statements)

References 45 publications

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“…A single dose of MTX was also used in a case where incomplete resection of the placenta from its vesical attachments was performed during hysterectomy. They proposed follow-up with interval exams and serial uterine imaging, β-hCG levels and coagulopathy assessments during medical management of invasive placental [65]. …”

Section: Resultsmentioning

confidence: 99%

Management of Abnormal Placenta Implantation with Methotrexate: A Review of Published Data

Farasatinasab

Moghaddas

Dashti-Khadivaki

et al. 2016

Gynecol Obstet Invest

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Abnormally invasive placenta is characterized by direct attachment of chorionic villi to the uterine wall. This adherent placenta traditionally has been managed by peripartum hysterectomy. Nowadays, there is a lot of interest toward gradual shift from traditional management of invasive placentation to conservative ones leaving the placenta in situ to avoid the surgical morbidity of hysterectomy and loss of future fertility. Administration of methotrexate (MTX), as an adjunctive antimetabolite drug, resulted in conflicting data during conservative management of abnormal placentation. This review assessed all published data on efficacy and safety of MTX therapy as conservative management of invasive placentation. Fifty-three articles including one prospective cohort study, 2 retrospective cohort studies, 10 case series and 40 case reports were identified. Conservative management has beneficial effects on the avoidance of major surgery with the consequent morbidity and the preservation of future fertility. Infection and vaginal bleeding were main complications of MTX therapy. Although MTX therapy may result in accelerated involution or expulsion of placenta and has some beneficial effects on hemorrhagic events, but there is not enough evidence on its efficacy and safety to recommend its routine uses in all cases of invasive placenta.

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Section: Resultsmentioning

confidence: 99%

Management of Abnormal Placenta Implantation with Methotrexate: A Review of Published Data

Farasatinasab

Moghaddas

Dashti-Khadivaki

et al. 2016

Gynecol Obstet Invest

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“…In a systematic review of surgical techniques used for PAS disorders, the overall rate of unintentional urinary tract injury at peripartum hysterectomy was 29% (83/285)—higher than rates for hysterectomies for other gynecologic indications . Seventy‐eight percent of injuries involve the bladder, whereas 17% involve the ureter . Modification of surgical technique has the ability to reduce urinary tract injury compared with standard hysterectomy .…”

Section: Preparation For the Operative Management Of Invasive Placentmentioning

confidence: 99%

FIGO consensus guidelines on placenta accreta spectrum disorders: Nonconservative surgical management,

Allen

Jauniaux

Hobson

et al. 2018

Intl J Gynecology & Obste

291

282

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“…The urinary tract is the most common affected pelvic structure with placenta accreta (25). Tam Tam et al reviewed 285 pregnancies complicated by morbidly adherent placentas that were managed with hysterectomy and found 29% chance of urinary tract injury.…”

Section: Managementmentioning

confidence: 99%

Placenta accreta: diagnosis, management and the molecular biology of the morbidly adherent placenta

Goh

Žalud

2015

The Journal of Maternal-Fetal & Neonatal Medicine

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Placenta accreta is now the chief cause of postpartum hemorrhage resulting in maternal and neonatal morbidity. Prenatal diagnosis decreases blood loss at delivery and intra and post-partum complications. Ultrasound is critical for diagnosis and MRI is a complementary tool when the diagnosis is uncertain. Peripartum hysterectomy has been the standard of therapy but conservative management is increasingly being used. The etiology of accreta is due to a deficiency of maternal decidua resulting in placental invasion into the uterine myometrium. The molecular basis for the development of invasive placentation is yet to be elucidated but may involve abnormal paracrine/autocrine signaling between the deficient maternal decidua and the trophoblastic tissue. The interaction of hormones such as Relaxin which is abundant in maternal decidua and INSL4, an insulin like peptide found in placental trophoblastic tissue may play role in the formation of placenta accreta.

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Approaches to reduce urinary tract injury during management of placenta accreta, increta, and percreta: a systematic review

Abstract: Antenatal diagnosis of INPLAT is paramount to minimize UT injury. Utilization of management modifications identified in this review may reduce urologic injury due to INPLAT.

Cited by 76 publications

References 45 publications

Management of Abnormal Placenta Implantation with Methotrexate: A Review of Published Data

Management of Abnormal Placenta Implantation with Methotrexate: A Review of Published Data

FIGO consensus guidelines on placenta accreta spectrum disorders: Nonconservative surgical management,

Placenta accreta: diagnosis, management and the molecular biology of the morbidly adherent placenta

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