Vol 83, No 7 (2012)
ARTICLES
Retrospective analysis of placenta accreta: management strategies – evaluation of 41 cases
Mehmet Siddik Evsen, Muhamment Erdal Sak, Hatice Ender Soydinc, Fatma Nur Caca, Mehmet Obut, Talip Gul
Vol 83, No 7 (2012)
ARTICLES
Abstract
Objective: The aim of the study was to evaluate maternal characteristics, surgical treatment options, and morbidity of patients with placenta accreta. Methods: We retrospectively reviewed the medical records of placenta accreta patients who were diagnosed and hospitalized between 2006 and 2010 at the Obstetrics and Gynecology Clinics of the Dicle University Hospital (Center A) and Maternity Hospital (Center B) in Diyarbakir, Turkey. The data were retrieved from medical charts of both hospitals. Maternal demographic features, clinical outcomes, type of surgical intervention, and complicationswere evaluated. Results: The incidence of placenta accreta was 1/426 deliveries in Center A and 1/7573 deliveries in Center B over a 5-year period. Thirty-nine (95.1%) patients had placenta previa, and 32 (78.0%) patients had at least one previous cesarean delivery. Hysterectomy was performed in 28 (68.3%) of 41 women with placenta accreta and uterine preservation was achieved in 13 (31.7%) of them. One (2.4%) maternal death occurred. Estimated blood loss was >2 liters and all patients required blood products transfusion. Conclusion: Placenta accreta is highly associated with the existence of placenta previa, especially in cases with previous cesarean delivery. When placenta accreta is diagnosed or suspected, the patient should be referred to a tertiary center for optimum care, where the obstetrical team should include experienced pelvic surgeons who are capable of performing emergent hysterectomy, internal iliac artery ligation, and uterine devascularization procedures.
Abstract
Objective: The aim of the study was to evaluate maternal characteristics, surgical treatment options, and morbidity of patients with placenta accreta. Methods: We retrospectively reviewed the medical records of placenta accreta patients who were diagnosed and hospitalized between 2006 and 2010 at the Obstetrics and Gynecology Clinics of the Dicle University Hospital (Center A) and Maternity Hospital (Center B) in Diyarbakir, Turkey. The data were retrieved from medical charts of both hospitals. Maternal demographic features, clinical outcomes, type of surgical intervention, and complicationswere evaluated. Results: The incidence of placenta accreta was 1/426 deliveries in Center A and 1/7573 deliveries in Center B over a 5-year period. Thirty-nine (95.1%) patients had placenta previa, and 32 (78.0%) patients had at least one previous cesarean delivery. Hysterectomy was performed in 28 (68.3%) of 41 women with placenta accreta and uterine preservation was achieved in 13 (31.7%) of them. One (2.4%) maternal death occurred. Estimated blood loss was >2 liters and all patients required blood products transfusion. Conclusion: Placenta accreta is highly associated with the existence of placenta previa, especially in cases with previous cesarean delivery. When placenta accreta is diagnosed or suspected, the patient should be referred to a tertiary center for optimum care, where the obstetrical team should include experienced pelvic surgeons who are capable of performing emergent hysterectomy, internal iliac artery ligation, and uterine devascularization procedures.
Keywords
Placenta Accreta, incidence, surgery, cesarean section
Title
Retrospective analysis of placenta accreta: management strategies – evaluation of 41 cases
Journal
Ginekologia Polska
Issue
Vol 83, No 7 (2012)
Page views
568
Article views/downloads
994
Bibliographic record
Ginekol Pol 2012;83(7).
Keywords
Placenta Accreta
incidence
surgery
cesarean section
Authors
Mehmet Siddik Evsen
Muhamment Erdal Sak
Hatice Ender Soydinc
Fatma Nur Caca
Mehmet Obut
Talip Gul