Individual decisions in placenta increta and percreta: a case series
-
Frédéric Chantraine
,
Michelle Nisolle
Abstract
Objective: Placenta increta or percreta is an uncommon pathology, sometimes associated with high maternal morbidity. Its prevalence increases proportionally to the number of cesarean sections. This study analyzed the changes of our management strategy to devise treatment guidelines for this uncommon disorder.
Materials and methodology: Between 2005 and 2011, 10 cases of placenta increta or percreta were managed at our university hospital maternity department.
Results: Among the 10 cases, seven were diagnosed prenatally. Two patients were diagnosed early, at 14 and 17 weeks of gestational age, and their pregnancies were terminated. Five had hysterectomies during the intrapartum period, and despite attempted conservative treatment for the two others, hysterectomy proved necessary 2 months postpartum because of intrauterine infections. Seven of the 10 women had hysterectomies.
Conclusion: Prenatal diagnosis of placenta increta or percreta is essential to plan the delivery in a competent tertiary care center. The decision to perform a cesarean hysterectomy or leave the placenta in situ for spontaneous delivery is based on the extent of infiltration, the patient’s hemodynamic status, and her desire to remain fertile. The high-risk of infection and severe hemorrhage must not be overlooked should conservative treatment be chosen. This situation requires prolonged close monitoring.
©2012 by Walter de Gruyter Berlin Boston
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- Review Article
- Retinal microvascular changes in low-birth-weight babies have a link to future health
- Original Articles – Obstetrics
- Chromosomal mosaicisms in prenatal diagnosis: correlation with first trimester screening and clinical outcome
- Perinatal impact of the use of metformin and glyburide for the treatment of gestational diabetes mellitus
- Incidence and causes of maternal thrombocytopenia in triplet gestation
- Maternal and paternal age and twinning in the United States, 2004–2008
- Correlates of the trend of cesarean section rates in twin pregnancies
- Prospective risk of stillbirth: monochorionic diamniotic twins vs. dichorionic twins
- Association between increased yolk sac diameter and abnormal karyotypes
- No “masculinization” effect of a male on birth weight of its female co-twin
- Comparison of risk calculation approaches in a screening programme for Down syndrome
- Individual decisions in placenta increta and percreta: a case series
- Original Articles – Fetus
- Fetal sex and perinatal outcomes
- Fetal magnetocardiography (fMCG): moving forward in the establishment of clinical reference data by advanced biomagnetic instrumentation and analysis
- Maternal and fetal cord blood lipids in intrauterine growth restriction
- Assessment of long-axis ventricular function in the fetal heart with a tissue-tracking algorithm
- Original Articles – Newborn
- A cluster of methicillin-sensitive Staphylococcus aureus colonization in a nursery
- Intermittent flushing improves cannula patency compared to continuous infusion for peripherally inserted venous catheters in newborns: results from a prospective observational study
- Opinion Paper
- Cross-over training in neonatology and obstetrics
- Congress Calender
- Congress Calendar
- Masthead
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