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Search Results: 1 - 10 of 487 matches for " Placenta Accreta "
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Placenta accreta
DJ Nizami,RT Awasthi,S Dash,J Verghese
Kathmandu University Medical Journal , 2009, DOI: 10.3126/kumj.v7i2.2710
Abstract: Total placenta accreta is a rare condition. Its management is a dilemma. Attempted separation of the placenta in placenta accreta can cause torrential blood loss. Therefore an antenatal diagnosis of placenta accreta permits advance planning of delivery. Two alternatives are caesarean section through the fundus with subsequent immediate hysterectomy, which has traditionally been the treatment of choice or if the patient wishes more children, leaving the placenta in place and managing conservatively1. We present a 38 year old lady who was diagnosed to have placenta accreta while performing a caesarean section for a breech presentation. We had to proceed with a total hysterectomy. DOI: 10.3126/kumj.v7i2.2710 Kathmandu University Medical Journal (2009) Vol.7, No.2 Issue 26, 149-151
Placenta ácreta: Diez a?os de experiencia en la Maternidad "Concepción Palacios"
Duarte S,Pablo C; Zighelboim,Itic;
Revista de Obstetricia y Ginecología de Venezuela , 2008,
Abstract: objective: to study the frequency of placenta accreta in pregnant patients in labor in the period 1994-2004 in a single university teaching maternity hospital. method: all pathology reports of obstetric hysterectomies were analized as well as the clinical charts of pregnant patients with diagnosis of placenta acreta percreta, and increta. setting: "the concepcion palacios" maternity in caracas-venezuela. results: we identified 30 cases (85.71 %) of placenta accreta, and 5 patients (14.9 %) with placenta percreta, that represents 0.014 % of obstetrical in patients and 0.62 % of the live newborns. the highest frequency of patients were between 31 to 40 years of age, and those who had 3-4 previous deliveries, with no relationship to previous cesarean sections. a 57.14 % of these women had no prenatal care. at time of delivery 54.29 % had between 21-36 weeks of gestation and 78.57 % were admitted in labor. in 71.43 % cesarean hysterectomy was performed after birth. fetal weight and length was ≥ 2 501 g and 43-47 cm in the majority of newborns. conclusions: this study represents a contribution to the study of these rare complication of pregnancy and the authors recommend the use of the present available technology for the diagnosis of this entity during pregnancy in order to reduce maternal morbidity and mortality.
Efficacy of Tourniquet Application in Minimizing Intraoperative Blood Loss in Cesarean Hysterectomies for Placenta Accreta—A Comparative Study  [PDF]
Pushplata Sankhwar, Shyam Pyari Jaiswar, Sujata Deo, Devyani Misra, Neha Negi
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.416143
Abstract: Objective: To assess the effect of tourniquet application of intraoperative blood loss in placenta accreta cases undergoing cesarean hysterectomy. Materials and methods: Nine cases and twenty controls with USG and colour Doppler diagnosed placenta accreta with previous cesarean section were chosen to utilize this novel approach. These cases were planned for elective cesarean section followed by hysterectomy. The twenty controls underwent a classical cesarean section followed by total abdominal hysterectomy with the placenta in situ. Among the nine cases, after delivery of the fetus through upper segment cesarean section, a cotton gauze tourniquet was applied all around the lower pole of uterus. Hysterectomy was performed with placenta in situ. Abdomen closed after achieving complete haemostasis. Results: The average operative time taken was 85 ± 11.72 minutes among cases and 98.25 ± 9.9 minutes among controls (p = 0.0039). Average blood loss was 1011.11 ± 99.3 ml among the cases and 1855 ± 222.95 ml among the controls (p ≤ 0.0001). Average requirement of blood transfusion required was two units for the cases and five units for the controls (p = 0.0002). No intra-operative or post-operative surgical complications were observed in any of the cases whereas the controls reportedly had a few. All the mothers and babies were healthy at the time of discharge. Conclusion: The presence of placenta accreta is associated with major fetal and maternal complications. The technique of tourniquet application is efficacious in minimizing the intra-operative blood loss and surgical complications due to obstruction of operative field by bleeding and also by preventing massive blood transfusion related complications.
Surgical Excision of Placenta with Lower Uterine Segment as a Conservative Management in a Case of Placenta Accreta: A Case Report  [PDF]
Ahmed Sherif Abdel Hamid Abdel Wahab, Mohamed Mohamed Yaseen
Open Journal of Obstetrics and Gynecology (OJOG) , 2018, DOI: 10.4236/ojog.2018.81008
Abstract: Introduction: Placenta accreta is due to invasive placental implantation. It is diagnosed when there is failure of delivery of a retained placenta. This is usually complicated by massive intrapartum hemorrhage that ends by hysterectomy. Case: We report a case of conservative management in a case of placenta accreta involving an elliptical shape incision of the lower segment with removal of placenta with underlying lower uterine segment in a stable patient desiring future fertility. Conclusion: Conservative management may be valid in carefully selected cases of placenta accreta diagnosed pre-operatively in tertiary hospitals with availability of blood-bank and multi-disciplinary approach.
Assessment of the Cases Undergone Peripartum Hysterectomy in a Tertiary Care Hospital in the Last Three Years  [PDF]
Afroz Sayma, Gulshan Ara
Open Journal of Obstetrics and Gynecology (OJOG) , 2018, DOI: 10.4236/ojog.2018.811101
Abstract: Background: Emergency peripartum hysterectomy (EPH), although rare in modern obstetrics, remains a life-saving procedure in cases of severe hemorrhage. Objective: To assess the incidence, indications, outcomes & complications of peripartum hysterecomty performed in a tertiary care hospital & compare the results with other reports in the literature. Methods: Twenty nine peripartum hysterectomy cases carried out between July 2015 and June 2018 in Enam Medical College & Hospital, Savar, Dhaka were evaluated retrospectively. Maternal characteristics and characteristics of the present pregnancy and delivery, hysterectomy indications, operative complications, postoperative conditions, and maternal and neonatal outcomes were evaluated. Results
Morbidly Adherent Placenta (MAP): Lessons learnt  [PDF]
Leena Wadhwa, Sangeeta Gupta, Pratibha Gupta, Bhawna Satija, Rupali Khanna
Open Journal of Obstetrics and Gynecology (OJOG) , 2013, DOI: 10.4236/ojog.2013.31A040
Abstract:

Context: Once a rare occurrence, MAP is becoming an increasing threat to maternal lives. Aims: To summarize our experience in the management of patients with morbidly adherent placenta. Introduction: MAP is a potentially life threatening hemorrhagic condition responsible for 7% - 10% maternal mortality. Settings and Design: Tertiary care center. Methods and Material: Retrospective study in which data of twelve patients with clinical diagnosis of morbidly adherent placenta was reviewed from Jan 2009 till Sept 2012. Results: The incidence of placenta accreta was found to be increasing every year. Out of twelve cases with clinical diagnosis of MAP, placenta previa was present in 10/12 patients with MAP. All patients had history of previous section. Two patients with preoperative diagnosis of MAP on USG/MRI were found to be normal intra-operative and in one patient focal accreta was diagnosed intraoperatively. Nine patients of MAP underwent caesarean hysterectomy due to excessive bleeding during placental separation and were confirmed histo-pathologically (3 accreta vera, 3 increta and 3 percreta). Internal iliac artery ligation was done in 2 patients. Two patients with placenta percreta had bladder rupture which was repaired and these two patients subsequently expired. Conclusions: The incidence of placenta accreta is increasing due to higher cesarean section (C/S) rate. Key to successful outcome is awareness, anticipation, preoperative counseling, planning and multidisciplinary approach.


Placenta percreta with silent rupture of the uterus
Passini Junior, Renato;Knobel, Roxana;Barini, Ricardo;Marussi, Emílio;
Sao Paulo Medical Journal , 1996, DOI: 10.1590/S1516-31801996000500006
Abstract: we report a case of placenta percreta diagnosed by ultrasound and color doppler image at the fourteenth week of gestation. initial approach was a trial of im methotrexate followed by total hysterectomy, during which was observed a rupture of the uterus with the adherence of the placenta to the posterior region of the bladder. we also present a literature review on the incidence of placenta percreta, etiology, diagnosis, treatment, and complications.
Alternative management in a case of placenta accreta with previous caesarean
Rajani M. Parikh,Kanaklata Nakum,A. V. Gokhle
International Journal of Reproduction, Contraception, Obstetrics and Gynecology , 2012, DOI: 10.5455/2320-1770.ijrcog001012
Abstract: The rate of caesarean is increasing day by day, and with it the chance of repeat caesarean. This has led to a rise in the chance of occurrence of placenta accreta. Control of bleeding is the main goal in such cases, which usually necessitates hysterectomy. But alternative methods are useful when retaining fertility is important. We present this case of a 30 yr old female who was admitted as a case of central placenta previa with previous caesarean. Per operatively, placenta was attached along the incision and baby was delivered by separating the placenta attached above the upper margin of incision. On attempting to remove the placenta attached to lower part of incision, it was found to be adherent along the previous scar. So placenta was removed piece meal, some part was left behind. Box sutures were taken over that part and uterine packing was done to control the bleeding. Post operatively the patient was fine and given injection Methotrexate on 8th day following the regime of 1, 3, 5, 7 days. She failed to expulse the placenta by 6wks, so D&E was done and retained products were removed. Leaving the placenta in situ followed by Methotrexate and interval removal of placenta can thus be helpful in conserving the uterus and hence, the fertility. [Int J Reprod Contracept Obstet Gynecol 2012; 1(1.000): 58-60]
Placenta Prévia: Fatores de risco para o Acretismo
Torloni, Maria Regina;Moron, Antonio Fernandes;Camano, Luiz;
Revista Brasileira de Ginecologia e Obstetrícia , 2001, DOI: 10.1590/S0100-72032001000700002
Abstract: purpose: to investigate risk factors associated with accretion in placenta previa (pp) patients. methods: this was a retrospective case-control study of all the records of patients who delivered between 1986-1998 at maternidade escola de vila nova cachoeirinha (s?o paulo) with a diagnosis of placenta previa. the groups with and without accretion were compared regarding age, parity, previous history of miscarriage, curettage and cesarean section, type of pp and predominant area of placental attachment. possible associations between the dependent (accretion) and independent (maternal and placental characteristics) variables were evaluated using the c2 test, univariate and multivariate analyses. results: reviewing 245 cases of pp, two risk factors were significantly associated with accretion: central placenta previa (odds ratio (or): 2.93) and two or more previous cesarean sections(or: 2.54). based on these data, a predictive model was constructed, according to which a patient with central pp and two more previous cesarean sections has a 44.4% risk for accretion. conclusions: results of the current study may help obstetricians in the classification of their patients with pp in different risk categories for accretion. this could be useful in preparing for possible delivery complications in those patients considered at a higher risk for accretion.
Outcome of Patients with Placenta Accreta at El Shatby Maternity University Hospital  [PDF]
Eman Ali AbdElfatah, Elsayed Elbadwy Mohamed Awad, Tamer Mamdouh Abd-Eldaym, Zynab Hassan Ali
Open Journal of Obstetrics and Gynecology (OJOG) , 2017, DOI: 10.4236/ojog.2017.77073
Abstract:
Objective: The aim of this study was to determine the incidence, risk factors, and outcomes of management of patients with placenta accreta. Background Placenta accreta occurs when the placental implantation is abnormal. The marked increase in incidence has been attributed to the increasing prevalence of cesarean delivery in recent years. The most common theory is defective decidualization. The most important risk factor for placenta accreta is placenta previa after a prior cesarean delivery. The first clinical manifestation of placenta accreta is usually profuse, life-threatening hemorrhage. The recommended management of suspected placenta accreta is planned preterm cesarean hysterectomy with the placenta left in situ. Patients and methods: It’s a study of all cases of placenta accreta at El-Shatby Maternity University Hospital starting from 1/4/2016 till 1/10/2016. Selection of the cases will only be dependent upon their pregnancy gestational age above 28 weeks of gestation. Results: The incidence of placenta accreta was 1/75 cesarean deliveries. The ultrasonography and doppler had a false negative rate of 54.6% and a sensitivity of 45.2% in diagnosis of placenta accreta. The rate of blood transfusion was 79.6%. Uterine preserving procedures performed in 66%. Cesarean hysterectomy performed in 34%. Intensive care unit admission occurred in 27.3%. The mean gestational age at delivery was 33.8 ± 4.6 weeks’ gestation. 31.8% admitted to the neonatal intensive care unit. Conclusion: The incidence of placenta accreta increased due to the increasing rate of cesarean deliveries, prenatal diagnosis of placenta accreta is paramount, as most women are asymptomatic. Prenatal diagnosis allows time for a multidisciplinary team to make delivery plans, which will help decrease surgical complications.
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