The morbidly adherent placenta: an overview of management options

Doumouchtsis, Stergios K.; Arulkumaran, Sabaratnam

doi:10.3109/00016349.2010.503869

Cited by 100 publications

(83 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…MTX, a folate antagonist, has been suggested as an adjunctive therapy in the conservative management for placenta accretes [9,10]. MTX acts against rapidly dividing cells and is effective against proliferating trophoblast.…”

Section: Introductionmentioning

confidence: 99%

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

Farasatinasab

Moghaddas

Dashti-Khadivaki

et al. 2016

Gynecol Obstet Invest

View full text Add to dashboard Cite

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.

show abstract

Section: Introductionmentioning

confidence: 99%

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

Farasatinasab

Moghaddas

Dashti-Khadivaki

et al. 2016

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…They have excessive hemorrhage, resulting in disorder of the clotting system and septicemia risks [26]. Hysterectomy is preferred in other cases [17,27].…”

Section: Discussionmentioning

confidence: 99%

Placenta accreta located in the posterior wall of the uterus: a case report

Özler¹,

Öztaş²,

Kadıoğlu³

et al. 2016

Med-Science

View full text Add to dashboard Cite

Abnormal invasive implantation of the placenta is thought to occur as a result of the defect in the decidua basalis of the women who have a history of cesarean delivery. Massive obstetric hemorrhage incidence is increased in placenta accreta cases. Although ultrasonographic and doppler examinations, and magnetic resonance imaging (MRI) are widely used, the diagnosis of placenta accreta in the early pregnancy weeks is poor. Therefore, the presence of life-threatening vaginal bleeding in the early pregnancy weeks must create a suspicion of placenta accreta. In this report, we will present a second trimester placenta accreta case, which was located on the posterior uterine wall.

show abstract

“…Des pertes de huit litres de sang sont survenues au cours du postpartum ne´cessitant une re´animation avec 3 800 mL de cristalloı¨des, 1 500 mL de colloı¨des, 16 Abnormal placental attachment (placenta accreta, increta, or percreta) can result in severe postpartum hemorrhage and is associated with significant morbidity and mortality. 1 The incidence of abnormal placentation has increased from approximately 0.8 per 1,000 deliveries in the 1980s to 3 per 1,000 deliveries in the past decade, [2][3][4] which is partly related to a rise in the rates of Cesarean delivery. 5 We present anesthetic management using a continuous spinal anesthesia (CSA) technique in a patient with placenta increta who underwent an elective Cesarean hysterectomy with massive postpartum hemorrhage.…”

Section: Résumémentioning

confidence: 99%