ArticleGynecologic oncology research and practice2017
Multidisciplinary approach to manage antenatally suspected placenta percreta: updated algorithm and patient outcomes.
Article in Gynecologic oncology research and practice, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 40 citations in OpenAlex.
- The utility of serum markers in the conservative management of placenta accreta spectrum (PAS) by leaving the placenta in situ in women with high-grade PAS.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Prophylactic Ghosh Uterine Compression Suture Technique to Prevent Severe Postpartum Hemorrhage in Placenta Accreta.Cureus · 2026Article
- Article
- Nonconservative vs. Conservative Management of Antenatally Diagnosed Placenta Accreta Spectrum Disorders: A Literature Review of Approaches and Outcomes.Obstetrics and gynecology international · 2025Review
- Placenta percreta invading left broad ligament in a woman with twin pregnancy: A case report.Annals of medicine and surgery (2012) · 2022Article
- Transfusion Requirements with Hybrid Management of Placenta Accreta Spectrum Incorporating Targeted Embolization and a Selective Use of Delayed Hysterectomy.American journal of perinatology · 2022Article
- A comparison of antenatally and intraoperatively diagnosed cases of placenta accreta spectrumJournal of the Turkish German Gynecological Association · 2020Article
- Elective robotic hysterectomy for placenta accreta spectrum in the second trimester: Case report.International journal of surgery case reports · 2020Article
- Laparoscopic hysterectomy to manage uterine rupture due to placenta percreta in the first trimester: A case report.Case reports in women's health · 2020Article
- Management of placenta percreta in a Jehovah's Witness patient.BMJ case reports · 2018Article
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Authors and funding
11 authors at 3 institutions in 1 country.
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Abstract
backgroundDue to the significant morbidity and mortality associated with placenta percreta, alternative management options are needed. Beginning in 2005, our institution implemented a multidisciplinary strategy to patients with suspected placenta percreta. The purpose of this study is to present our current strategy, maternal morbidity and outcomes of patients treated by our approach.
methodsFrom 2005 to 2014, a retrospective cohort study of patients with suspected placenta percreta at an academic tertiary care institution was performed. Treatment modalities included immediate hysterectomy at the time of cesarean section (CHYS), planned delayed hysterectomy (interval hysterectomy 6 weeks after delivery) (DH), and fertility sparing (uterine conservation) (FS). Prognostic factors of maternal morbidity were identified from medical records. Complications directly related to interventional procedures and DH was recorded. Descriptive statistics were utilized.
resultsOf the 21 patients with suspected placenta percreta, 7 underwent CHYS, 13 underwent DH, and 1 had FS with uterine preservation. Of the 20 cases that underwent hysterectomy, final pathology showed 11 increta, 7 percreta, and 2 inconclusive. 19/20 cases underwent interventional radiology (IR) procedures. Selective embolization was utilized in 14 cases (2/7 CHYS; 12/13 DH). The median time from cesarean section (CS) to DH was 41 [26-68] days. There were no cases of emergent hysterectomy, delayed hemorrhage, or sepsis in the DH group. Both estimated blood loss and number of packed red blood cell transfusions were significantly higher in the CHYS group. 3/21 cases required massive transfusion (2 CHYS, 1 FS) with median total blood product transfusion of 13 units [12-15]. The four IR-related complications occurred in the DH group. Incidence of postoperative complications was similar between both groups. Median hospital length of stay (LOS) after CHYS was 4 days [3-8] compared to DH cohort: 7 days [3-33] after CS and 4 days [1 -10] after DH. The DH cohort had a higher rate of hospital readmission of 54% (7/13) compared to 14% (1/7) CHYS, most commonly due to pain. There were no maternal deaths.
conclusionThis multidisciplinary strategy may appear feasible; however, further investigation is warranted to evaluate the effectiveness of alternative approaches to cesarean hysterectomy in cases of morbidly adherent placenta.
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