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Vol 82, No 6 (2011)
ARTICLES
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Placenta praevia increta with caesarean section scar invasion

Izabela Ulman-Włodarz, Krzysztof Nowosielski, Ryszard Poręba, Aneta Poręba
Ginekol Pol 2011;82(6).

open access

Vol 82, No 6 (2011)
ARTICLES

Abstract

Abstract Introduction: Placenta increta refers to the placenta invading the myometrium. It is a rare but life-threatening condition. The incidence of placenta increta ranges widely from 1 in 540 to 1 in 93,000 deliveries; in Poland it is approximately 0.2% of all deliveries. The occurrence of placenta praevia increta is much lower and accounts for 0.001% to 0.05% of cases. However, the frequency of this condition is steadily increasing. Case report: Placenta praevia was diagnosed in an ultrasound examination at 20 weeks’ gestation in a multipara who had previously delivered by caesarean section. The invasion of the placental vessels into the caesarean section scar was observed in a Colour Doppler scan. The patient was admitted for a planned caesarean section at 36 weeks’ gestation and invasion of the vessels into the caesarean scar was confirmed . Because of uncontrolled hemorrhage, a total abdominal hysterectomy was performed. The patient had an uneventful recovery and was discharged well on the fourth postoperative day with a healthy infant. Conclusions: Early antenatal detection of placenta praevia increta and planning the surgical intervention tailored to available resources and the patient’s expectations result in reducing the number of postpartum maternal, as well as neonatal complications.

Abstract

Abstract Introduction: Placenta increta refers to the placenta invading the myometrium. It is a rare but life-threatening condition. The incidence of placenta increta ranges widely from 1 in 540 to 1 in 93,000 deliveries; in Poland it is approximately 0.2% of all deliveries. The occurrence of placenta praevia increta is much lower and accounts for 0.001% to 0.05% of cases. However, the frequency of this condition is steadily increasing. Case report: Placenta praevia was diagnosed in an ultrasound examination at 20 weeks’ gestation in a multipara who had previously delivered by caesarean section. The invasion of the placental vessels into the caesarean section scar was observed in a Colour Doppler scan. The patient was admitted for a planned caesarean section at 36 weeks’ gestation and invasion of the vessels into the caesarean scar was confirmed . Because of uncontrolled hemorrhage, a total abdominal hysterectomy was performed. The patient had an uneventful recovery and was discharged well on the fourth postoperative day with a healthy infant. Conclusions: Early antenatal detection of placenta praevia increta and planning the surgical intervention tailored to available resources and the patient’s expectations result in reducing the number of postpartum maternal, as well as neonatal complications.
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Keywords

placenta increta, Placenta Praevia, cesarean section, Case Management

About this article
Title

Placenta praevia increta with caesarean section scar invasion

Journal

Ginekologia Polska

Issue

Vol 82, No 6 (2011)

Bibliographic record

Ginekol Pol 2011;82(6).

Keywords

placenta increta
Placenta Praevia
cesarean section
Case Management

Authors

Izabela Ulman-Włodarz
Krzysztof Nowosielski
Ryszard Poręba
Aneta Poręba

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