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Article: Planned conservative management of placenta accreta-experience of a regional general hospital

TitlePlanned conservative management of placenta accreta-experience of a regional general hospital
Authors
KeywordsAdherent placenta
Uterine artery embolization
Placental conservation
Hysterectomy
Previous cesarean section
Issue Date2014
Citation
Journal of Maternal-Fetal and Neonatal Medicine, 2014, v. 27, n. 3, p. 291-296 How to Cite?
AbstractObjective: There are only a few series treating ≥10 cases of accreta conservatively, all from university teaching hospitals, with reported success rate of 60-85%. We reported the first series of accreta managed by planned uterine conservation in the setting of non-university district general hospital. Methods: Women with placenta previa overlying previous cesarean scar who desired uterine conservation were included. For cases with accreta confirmed during cesarean delivery, placenta was purposefully left behind, followed immediately by uterine artery embolization. Cases were followed in our special postnatal clinic. Charts were reviewed to retrieve clinical details. Results: Among 15 cases of placenta previa overlying cesarean scar opting for conservative management, 12 (80%) were confirmed to be accreta intra-operatively. They had 20-100% of the adherent placentae retained (median 90%) and their uterus preserved. Postpartum, abnormal vaginal bleeding and/or infection led to unscheduled readmission in 67% (8/12), all managed conservatively. Sonographic resolution of placenta took 2-13 months (median 6.6), and was later than menstrual return in 11 cases. Conclusions: Successful planned conservative management of placenta accreta is feasible in the setting of district general hospital with facilities for interventional radiology. © 2014 Informa UK Ltd. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/244158
ISSN
2015 Impact Factor: 1.674
2015 SCImago Journal Rankings: 0.810

 

DC FieldValueLanguage
dc.contributor.authorLo, Tsz Kin-
dc.contributor.authorYung, W. K.-
dc.contributor.authorLau, W. L.-
dc.contributor.authorLaw, Bassanio-
dc.contributor.authorLau, Samuel-
dc.contributor.authorLeung, W. C.-
dc.date.accessioned2017-08-31T08:56:12Z-
dc.date.available2017-08-31T08:56:12Z-
dc.date.issued2014-
dc.identifier.citationJournal of Maternal-Fetal and Neonatal Medicine, 2014, v. 27, n. 3, p. 291-296-
dc.identifier.issn1476-7058-
dc.identifier.urihttp://hdl.handle.net/10722/244158-
dc.description.abstractObjective: There are only a few series treating ≥10 cases of accreta conservatively, all from university teaching hospitals, with reported success rate of 60-85%. We reported the first series of accreta managed by planned uterine conservation in the setting of non-university district general hospital. Methods: Women with placenta previa overlying previous cesarean scar who desired uterine conservation were included. For cases with accreta confirmed during cesarean delivery, placenta was purposefully left behind, followed immediately by uterine artery embolization. Cases were followed in our special postnatal clinic. Charts were reviewed to retrieve clinical details. Results: Among 15 cases of placenta previa overlying cesarean scar opting for conservative management, 12 (80%) were confirmed to be accreta intra-operatively. They had 20-100% of the adherent placentae retained (median 90%) and their uterus preserved. Postpartum, abnormal vaginal bleeding and/or infection led to unscheduled readmission in 67% (8/12), all managed conservatively. Sonographic resolution of placenta took 2-13 months (median 6.6), and was later than menstrual return in 11 cases. Conclusions: Successful planned conservative management of placenta accreta is feasible in the setting of district general hospital with facilities for interventional radiology. © 2014 Informa UK Ltd. All rights reserved.-
dc.languageeng-
dc.relation.ispartofJournal of Maternal-Fetal and Neonatal Medicine-
dc.subjectAdherent placenta-
dc.subjectUterine artery embolization-
dc.subjectPlacental conservation-
dc.subjectHysterectomy-
dc.subjectPrevious cesarean section-
dc.titlePlanned conservative management of placenta accreta-experience of a regional general hospital-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.3109/14767058.2013.818118-
dc.identifier.pmid23796273-
dc.identifier.scopuseid_2-s2.0-84891955616-
dc.identifier.volume27-
dc.identifier.issue3-
dc.identifier.spage291-
dc.identifier.epage296-
dc.identifier.eissn1476-4954-

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