Placenta Accreta: Obstetrician's Nightmare; A Case Series of Seven Patients

Choudhary, Deepti; Nigam, Aruna; Yadav, Reena; Choudhary, Soni; Chitra, R.

doi:10.3126/njog.v7i1.8839

Cited by 5 publications

(6 citation statements)

References 4 publications

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“…Also, other investigators reported similar results. In Choudhary et al study all patients were multiparous with 84%, in study by Fitzpatrick et al also, concurrent placenta praevia was recorded in 53% cases, which is lesser compared to 71% in study by Choudhary et al 2 and 64% in study by Fizpatrick et al [10][11][12] According to the current findings, blood transfusion was required in all 166 cases of placenta accreta spectrum. A recent study published in 2018 found that 94.7% of placenta accrete cases required blood transfusion, while another study found that 75.0% cases required blood transfusion.…”

Section: Discussionmentioning

confidence: 43%

Evaluation of outcome of pregnancy in placenta accreta spectrum

Veludandi¹,

Suman²,

Nagamani³

et al. 2021

Int J Reprod Contracept Obstet Gynecol

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Background: Aim of the study was to evaluate the outcome of pregnancy in placenta accrete spectrum in third trimester pregnancy at tertiary care centreMethods: This hospital based retrospective study was carried out from 2017 to 2019. The case records of all women identified as placenta accrete spectrum from the hospital registers were retrieved. A total of 166 patients with the diagnosis of placenta accrete spectrum were included in the study.Results: The incidence of morbidly adherent placenta is 5 per 10,000 deliveries with mean age being 32.4±4.2 (23-39) years. and showed its relation with risk factors such as previous caesarean section (CS), placenta praevia and multiparity. The mean duration of MICU stay in placenta previa was 6.7±1.9 days (range 2-12 days). With complications in 18 cases of which urinary bladder injury (3%), infection (9%), PPH and coagulopathy (4.2%). The placenta was removed successfully in 141 while 25 cases had caesarean hysterectomy (2.4%). In total 166 cases 26 (16.8%) cases are intrauterine device (IUD) and still births. 5 (3%) cases are very low birth weight, 24 cases (14.5%) are low birth weight babies, 76 (45.8%) cases had neonatal intensive care unit (NICU) admissions followed by 10 (6%) cases with <5 APGAR score.Conclusions: Placenta accreta spectrum can be identified antenatally with a high index of suspicion in the presence of known risk factors and proper radiological studies, allowing for planned attempts to avoid life-threatening haemorrhage and caesarean hysterectomy.

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Section: Discussionmentioning

confidence: 43%

Evaluation of outcome of pregnancy in placenta accreta spectrum

Veludandi¹,

Suman²,

Nagamani³

et al. 2021

Int J Reprod Contracept Obstet Gynecol

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“…Present study showed history of previous caesarean section in 76% cases, which highlights the established risk associated with it, in comparison it is 85% in study by Chaudhary D et al 2 Placenta Accreta has an incidence of 1 in 2500 deliveries as per Morgan M et al 5 and 1.7 per 10,000 deliveries as per Fitzpatrick et al 3 . Incidence in this study is 4.3 per 10,000 deliveries.…”

Section: Discussionmentioning

confidence: 80%

“…Also accreta syndromes are one of the leading causes of intractable post partum haemorrhage and emergency peripartum hysterectomy. Recent studies have demonstrated increased incidence of placenta accreta syndrome 2,3 . Anterpartum diagnosis can be made using colour Doppler as early as second trimester.…”

mentioning

confidence: 99%

Placenta accreta syndrome: A rising epidemic in obstetrics

Patil¹,

Puranik²,

Vishwasrao³

2018

OBGYN

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Objectives:The aims of our study were to determine incidence of placenta accreta syndrome and correlate it with the risk factors. Methods: A clinicohistopathological study had been done on the basis of clinical, radiological and histopathogical analysis. Obstetric hysterectomy specimens were studied and those diagnosed as placenta accreta syndrome were investigated in detail for history of Caesarean section. Results: The incidence of placenta accreta syndrome is 4.3 per 10,000 deliveries. The study revealed the placenta accreta syndrome in younger age group (mean age 27 yrs) and showed its relation with risk factors such as previous caesarean section (76% cases), placenta praevia (53% cases) and multiparity (92%). Conclusions: With high index of suspicion in presence of known risk factors and appropriate radiological investigations, this syndrome can be diagnosed antenatally and planned efforts to avoid life threatening haemorrhage and early hysterectomy can be made.

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“…In a case series of seven patients, conservative management in two cases failed and one case required delayed hysterectomy while bleeding continued per vaginally in the other case and it emphasizes to check for PV bleed intraoperatively if the placenta is left in situ. 10 We describe a severe case of placenta percreta, in which the placenta was left in situ during cesarean section and a classical uterine incision was used for extraction of the fetus to avoid the morbidly adherent low placenta with bilateral internal iliac artery ligation. The placenta was left in situ, because spontaneous separation of placenta did not take place.…”

Section: Discussionmentioning

confidence: 99%

Placenta percreta with bladder invasion – a novel approach for management: A case report

Kharkwal

Jain

et al. 2022

Asian J Med Sci

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Placenta percreta is an obstetric emergency often associated with massive hemorrhage, emergency cesarean section, and peripartum hysterectomy. We present a case of a 30-year-old woman, G4P1L1A2 with placenta percreta managed by an alternative approach. The placenta was left in situ along with B/L internal iliac artery ligation during cesarean section and later on delayed subtotal hysterectomy with bladder repair was successfully performed. Placenta percreta spectrum is an obstetricians dilemma associated with massive hemorrhage and is a potential life-threatening condition for both mother and the baby. Cesarean section with B/L internal iliac artery ligation and delayed hysterectomy may be a reasonable strategy in the most severe cases.

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Placenta Accreta: Obstetrician's Nightmare; A Case Series of Seven Patients

Cited by 5 publications

References 4 publications

Evaluation of outcome of pregnancy in placenta accreta spectrum

Evaluation of outcome of pregnancy in placenta accreta spectrum

Placenta accreta syndrome: A rising epidemic in obstetrics

Placenta percreta with bladder invasion – a novel approach for management: A case report

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