Risk Factors for Placenta Accreta

Hung, Tai‐Ho; Shau, Wen–Yi; Hsieh, Chia Chien; Chiu, Tsung‐Hong; Hsu, Jane Yung-jen; Hsieh, T’sang‐T’ang

doi:10.1097/00006250-199904000-00015

Cited by 79 publications

(122 citation statements)

References 17 publications

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“…The most common risk factor for adherent placenta and placenta percreta is cesarean section. Besides cesarean delivery further risk factors are reported as multiparity, uterine fibroids, embolization of uterine fibroid, advanced maternal age, second-trimester serum levels of alpha-fetoprotein (AFP) and free beta-hCG greater than 2.5 multiples of the median without any anatomical malformation, hypertensive disorders, or smoking [5][6][7], any condition resulting in myometrial tissue damage such as previous myomectomy, endometritis, endometrial defects due to curettage resulting in Asherman syndrome [8], thermal ablation [9], and uterine artery embolization [10]. Such abnormalities include placenta previa as well as placenta accreta.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Surgical Treatment of Undiagnosed Placenta Percreta

Molnár¹,

Surányi²,

Jakó³

et al. 2016

J Clin Case Rep

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Section: Introductionmentioning

confidence: 99%

Intraoperative Surgical Treatment of Undiagnosed Placenta Percreta

Molnár¹,

Surányi²,

Jakó³

et al. 2016

J Clin Case Rep

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“…3,[7][8][9] In addition, in trisomy 21 screening programmes, an association was found between PA and abnormally elevated second-trimester alpha fetal protein (AFP) and free b subunit of human chorionic gonadotrophin (b-hCG) levels in maternal serum. 10 The reported incidence of PA varies widely, mainly as it is affected by differences in diagnostic criteria, i.e. whether the diagnosis was based on clinical findings only or together with histological criteria.…”

Section: Introductionmentioning

confidence: 99%

Placenta accreta is associated with IVF pregnancies: a retrospective chart review

Esh-Broder¹,

Ariel

Abas-Bashir³

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

172

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deliveries occurred in our hospital, including 752 (3%) deliveries of IVF pregnancies.Methods Placenta accreta was only diagnosed when there were histological findings from the placenta associated with the suitable clinical course. Demographic, obstetrical and fertility characteristics of these patients were retrieved from hospital files.Main outcome measure Rates of PA in pregnancies achieved with IVF versus rates of PA in spontaneous pregnancies.Results The rate of PA in the IVF group was 12/752 (16/1000) pregnancies, compared with 30/24 441 (1.2/1000) among spontaneous pregnancies (P < 0.0001; OR 13.2; 95% CI 6.7-25.8). Among the variables examined, parity, rate of caesarean delivery in the index pregnancy, and birthweight differed significantly between IVF and spontaneous pregnancies.Conclusions The odds of developing PA are significantly higher in IVF pregnancies than in spontaneous pregnancies. These differences may stem from differences in the endometrial environment, or from changes to the endometrium wrought by IVF treatment protocols.

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“…If placenta praevia is complicated by accreta and percreta the risk is even higher. As a result of the increasing number of surgical deliveries incidence of these conditions are rising [1,2]. Placenta accreta occurs most frequently in women with one or more prior cesarean deliveries who have a placenta previa in the current pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Placenta Previa Combined with Placenta Accreta and Fetal Congenital High Airway Obstruction- Failed Ex Utero Intrapartum Treatment

Solanki¹

2015

Glob J Anesth

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057within normal limits. Blood pressure was 110/80 mmHg and heart rate was 82/minute. Airway examination revealed mouth opening of 3 cm. She was mallampatti class II with full range of neck movement. Tablet ranitidine 150 mg and metoclopramide 10 mg was given night before surgery and in morning on day of surgery. In the operating room, standard 5 leads ECG, NIBP and pulse oximetry were attached and baseline parameters were noted. Two large bore (16 G) venous cannulae were secured in upper limbs and normal saline infusion was started. ENT and pediatric surgeons were kept ready for surgery and procedures on baby. After preoxygenation with 100% for 5 minute (target endtidal oxygen >90%), rapid sequence anesthesia was induced with IV thiopentone 325 mg and IV suxamethonium 125 mg. Trachea was secured with 7.0 mm ID tracheal tube. IV atracurium 25 mg was given once the effect of suxamethonium was tapered. Anesthesia was maintained with isoflurane in a mixture of oxygen and nitrous oxide (30:70). Right internal jugular central venous catheterization was done and radial artery was cannulated for continuous invasive blood pressure monitoring. Surgical plan was to perform ex utero intrapartum treatment (EXIT) on fetus after classical cesarean incision if the maternal bleeding will be under control. Surgery was allowed to start. Uterus was opened and baby was delivered out. As soon as the baby was delivered profuse bleeding was started from uterus and placenta. It was decided not to perform EXIT procedure and cord was clamped and cut. Bleeding was continued from uterus and placenta. Three units of packed red blood cells and three units of fresh frozen plasma were transfused. Meanwhile ENT surgeon performed tracheostomy on baby and airway was secured but baby died after half an hour. All measures to control the bleeding were failed. Bleeding was continued from uterus and placenta, hysterectomy was done. Blood loss was around 2500 IntroductionPlacental abnormalities like placenta previa and accreta are more common in parturient with prior history of cesarean delivery. They are prone to cause massive bleeding during cesarean and emergency cesarean hysterectomy has to be performed to save the life of mother. If such a condition is associated with fetal airway abnormalities then condition may be even worse. We here describe a case of parturient with placenta previa-accreta and fetal congenital high airway obstruction posted for cesarean section. Case ReportA 26 year old G2P1001 parturient was admitted at 32 weeks of pregnancy for obstetric services. She was a diagnosed case of placenta previa grade III with placenta accreta. Ultrasonography (USG) at 16 weeks of pregnancy showed normal fetal skull, spine and stomach. At 26 weeks of pregnancy USG showed low lying placenta anteriorly covering internal os, moderate to severe fetal hydrocephalus with dilated lateral ventricles (1.9 cm), single upper limb and short other limbs, skeletal dysplasia and over-distended fetal abdomen with large cystic masses. Level II obstetric USG at 28...

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Risk Factors for Placenta Accreta

Cited by 79 publications

References 17 publications

Intraoperative Surgical Treatment of Undiagnosed Placenta Percreta

Intraoperative Surgical Treatment of Undiagnosed Placenta Percreta

Placenta accreta is associated with IVF pregnancies: a retrospective chart review

Placenta Previa Combined with Placenta Accreta and Fetal Congenital High Airway Obstruction- Failed Ex Utero Intrapartum Treatment

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