This is a retrospective review of all the patients who had a caesarean section for suspected placenta acreta in St Vincent’s Hospital (SVH) from December 2008 to October 2011.
The study includes all women who were referred to SVH for caesarean section with an antenatal diagnosis of placenta acreta/percreta. The review included patient’s age, parity and previous caesarean sections, antenatal diagnosis with ultrasound and MRI, hysterectomies performed, conservative management, ICU/HDU admissions after the procedure and radiological input. The review excludes women who had caesarean sections in SVH for other indications.
Results During the period 11 women had caesareans sections in SVH, 6 of these women had a caesarean section for suspected placenta acreta. The average age was 35.6 years. All 6 had antenatal ultrasound and 5 had MRI.1 3 were diagnosed with placenta percreta and required bladder repair. 5 women had a caesarean hysterectomy. 4 women required ICU admission, 2 were admitted to HDU. 1 had conservative management with uterine artery embolization day 2 post operatively followed by manual removal of placenta at 8 weeks.2 2 women had a blood loss greater than 4 litres. All 6 women had female infants. All 6 had a history of previous caesarean section. 1 woman had 4 previous D&Cs for recurrent miscarriage. 3 had uterine artery embolization.3
Conclusion This review looks at the diagnosis and management of placenta acreta in a large tertiary centre and reviews the role of a multidisciplinary approach to its management.4
LA McLean, ME Heilbrun, PJ Woodward. Assessing the role of magnetic resonance imaging in the management of gravid patients at risk for placenta acreta. Acad Radiol 2011;18:1175–1180.
BC Chan, HS Lam, CP Lee. Conservative management of placenta praevia with acreta. Hong Kong Med J 2008;14:479–84.
AP Rao, H Bojahr, I Renfrew. Role of interventional radiology in the management of morbidly adherent placenta. J Obstet Gynaecol 2010;30:687–9.
E Hayes, G Ayida, A Crocker. The morbidly adherent placenta: diagnosis and management options. Curr Opin Obstet Gynaecol 2011 Oct 14.
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