Maternal Morbidity in Cases of Placenta Accreta Managed by a Multidisciplinary Care Team Compared With Standard Obstetric Care

Eller, A.G.; Bennett, Michele A.; Sharshiner, Rita; Masheter, Carol; Soisson, Andrew P.; Dodson, Mark K.; Silver, R.M.

doi:10.1097/01.aoa.0000410804.39007.f9

Cited by 53 publications

(74 citation statements)

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“…In a study conducted by A.G Eller benefits of multidisciplinary care for women with suspected placenta accreta have been evaluated They found that women managed by a multidisciplinary team were less likely to experience composite early morbidity (prolonged maternal admission to the intensive care unit, largevolume blood transfusion, coagulopathy, ureteral injury, or early reoperation) than women managed standard obstetric care. 21 The mean gestational age at delivery was 35±2.4 weeks ranging from 27.5wks -39 wks. Prematurity as a neonatal complication has been reported in earlier studies also.…”

mentioning

confidence: 98%

Current placenta previa management and outcome in a rural tertiary care centre

Sood

Sharma

Nagpal

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: The reported incidence for placenta previa averages 0.3% or 1 case in 300 to 400 deliveries. Multiparity, advanced maternal age, cigarette smoking, previous caesarean delivery, history of abortions or uterine surgical procedures are some of the risk factors contributing to the development of placenta previa. Massive obstetrical haemorrhage in placenta previa is associated with severe maternal morbidity and mortality. A significant number of mothers can be saved if right approach of management is followed in placenta previa.Methods: The present case study is a retrospective analysis carried out in a tertiary care centre to study the risk factors and maternal and perinatal outcome in cases of placenta previa. The study included antenatal patients diagnosed as placenta previa on sonography at or >26 weeks of pregnancy. Data was compiled and statistically analysed.Results: Incidence of Placenta Previa in our study was 0.54%. 73.2% patients had history of previous cesarean sections. 53.6% patients were referred from outside. 98.2% patients delivered by caesarean section. Obstetric hysterectomy was required in 3.5% of total cases. 10.7% cases required the ICU admission after delivery. There was no maternal mortality in the study group. The mean gestational age at delivery was 35±2.4weeks. The mean APGAR at 5 min was 9±2.2.Conclusions: Increasing rates of caesarean sections in present era indicate that incidence of Placenta Previa is expected to rise. Good antenatal care, availability of emergency obstetric services, infrastructure, blood bank facility, HDU and ICU care and NICU services can improve maternal and neonatal outcome.

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mentioning

confidence: 98%

Current placenta previa management and outcome in a rural tertiary care centre

Sood

Sharma

Nagpal

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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show abstract

“…In carefully selected cases, when fertility is desired, conservative management may be considered with caution. Delivery planning may involve an anesthesiologist, senior obstetrician, pelvic surgeon such as a gynecologic oncologist, intensivist, neonatologist, urologist, hematologist, and interventional radiologist to optimize the patient's outcome [19]. The delivery should be performed by an experienced obstetric team that includes an obstetric surgeon, with other surgical specialists, such as urologists, general surgeons, and gynecologic oncologists, available if necessary.…”

Section: Discussionmentioning

confidence: 99%

Successful conservative management in placenta previa percreta involving urinary bladder

et al. 2014

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“…Such strategies include leaving the placenta in situ, combined with uterine artery embolisation or uterine compression sutures, and the use of methotrexate to inhibit trophoblast growth. However, these conservative approaches may be limited by the high risk of bleeding, infection and poor placental absorption [62][63][64].…”

Section: Other Strategies For the Management Of Abnormal Placentationmentioning

confidence: 99%

“…Furthermore, some studies have recommended that patients with placenta accreta, increta or percreta who have no attempt to remove any of their placentae, with the aim of conserving their uterus, have reduced levels of haemorrhage and a reduced need for blood transfusion [62][63][64].…”

Section: Techniquementioning

confidence: 99%