Suspected placenta accreta and cesarean hysterectomy: observational cohort utilizing an intraoperative decision strategy

European Journal of Obstetrics, Gynecology, and Reproductive Biology
Carolyn F WeinigerDeirdre J Lyell

Abstract

Planned cesarean hysterectomy (CH) is recommended to minimize morbidity for suspected placenta accreta (PA), yet this ends fertility. We examined CH frequency and post-operative morbidities for suspected PA cases when an intra-operative decision strategy to perform CH was used. Suspected PA cases were pre-operatively identified in one tertiary care center. Women were assessed intra-operatively, prior to uterine incision, for immediate CH or for attempted placental separation. We compared outcomes among women with versus without PA (surgical and/or pathologic diagnosis), and examined outcomes following immediate CH versus attempted placental separation. Our cohort, from 2002 to 2012, comprised 99 women with suspected PA; 54 (54.5%) had PA diagnosed by surgery/pathology, and 45 (45.5%) did not. Among women diagnoses surgically or pathologically with PA, CH was performed for 46/54 (85%); 8 women with suspected PA had successful placental separation. 27 of the 46 CH were performed immediately following uterine wall examination and 19 were performed following attempted placental separation. We received histological confirmation of the clinical placenta accreta diagnosis for 24/46 (52.2%) cases, and in 22/46 (47.8%) cases the histolo...Continue Reading

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Citations

Mar 8, 2016·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Shigeki Matsubara
Apr 12, 2016·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Carolyn F Weiniger, Deirdre J Lyell
May 1, 2016·European Journal of Obstetrics, Gynecology, and Reproductive Biology·S MatsubaraH Fujiwara
Jun 25, 2016·Journal of Vascular and Interventional Radiology : JVIR·Francesco GiurazzaFranco Maglione
Jun 25, 2016·Journal of Vascular and Interventional Radiology : JVIR·Shigeki Matsubara
Sep 15, 2017·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·Şehmus PalaBurçin Kavak
Feb 7, 2018·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Lisa AllenUNKNOWN FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel
Mar 22, 2019·Archives of Gynecology and Obstetrics·Ahmed M Hussein, Ahmed Kamel
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Mar 31, 2021·International Journal of Obstetric Anesthesia·B D Einerson, C F Weiniger

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