scholarly journals Simplified conservative surgery for placenta accreta spectrum (PAS): an abnormally invasive placenta (AIP) case

2021 ◽  
Vol 14 (1) ◽  
pp. e237960
Author(s):  
Abdalla Mousa ◽  
Islam Tarek Elkhateb
Keyword(s):  
Placenta Accreta ◽  
Conservative Surgery ◽  
Invasive Placenta ◽  
Placenta Accreta Spectrum ◽  
Abnormally Invasive Placenta

scholarly journals Uterine Artery Embolization for Management of Placenta Accreta, a Single-center Experience and Literature Review

2017 ◽  
Vol 01 (01) ◽  
pp. 37-42
Author(s):  
Abdallah Noufaily ◽  
Raja Achou ◽  
Mitri Ashram ◽  
Miziana Mokbel ◽  
Emile Dabaj ◽  
...  
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Placenta Accreta ◽  
Rectal Wall ◽  
Artery Embolization ◽  
Single Center Experience ◽  
Invasive Placenta ◽  
Abnormally Invasive Placenta

Abstract“Morbidly adherent placenta” is a term that describes the continuum of placenta accreta, increta, and percreta. Placenta accreta is the least invasive form, whereas placenta percreta represents a complete penetration of the trophoblast through the uterus that reaches the serosal surface and potentially invades the bladder, rectal wall, and pelvic vessels. Leaving the placenta in situ in the setting of abnormally invasive placenta is now widely practiced. We herein present three cases of abnormal placental implantation diagnosed by antenatal ultrasound and magnetic resonance imaging, in which uterine artery embolization was performed to induce placental infarction and eventually rapid regression but most importantly to minimize peripartum and postpartum bleeding. As we do this, we sought to review the risks of placenta accreta, increta, and percreta and evaluate the role of endovascular therapy to improve maternal outcomes when abnormal placental implantation occurs.

scholarly journals Trophoblast invasion: Lessons from abnormally invasive placenta (placenta accreta)

Placenta ◽  
2020 ◽  
Vol 102 ◽  
pp. 61-66 ◽  
Author(s):  
Nicholas P. Illsley ◽  
Sonia C. DaSilva-Arnold ◽  
Stacy Zamudio ◽  
Manuel Alvarez ◽  
Abdulla Al-Khan
Keyword(s):  
Placenta Accreta ◽  
Trophoblast Invasion ◽  
Invasive Placenta ◽  
Abnormally Invasive Placenta

scholarly journals One step conservative surgery: an approach to manage placenta accreta spectrum

2021 ◽  
Vol 10 (7) ◽  
pp. 2884
Author(s):  
Soniya Dahiya ◽  
Pushpa Dahiya ◽  
Shweta Jain ◽  
Sunita .
Keyword(s):  
Caesarean Section ◽  
Postpartum Hemorrhage ◽  
Placenta Accreta ◽  
Caesarean Section Rate ◽  
Conservative Surgery ◽  
Emergency Laparotomy ◽  
One Step ◽  
Placenta Accreta Spectrum ◽  
Labour Room ◽  
Caesarean Hysterectomy

The incidence of placenta accreta spectrum (PAS) has been arisen over past few decade, attributed to increasing caesarean section rate from 1:2500 to 1:500. Caesarean hysterectomy cases are increasing to prevent morbidity and mortality in PAS. The conservative approach for PAS is to prevent postpartum hemorrhage and to preserve the uterus. We present a case of placenta accreta spectrum where we had done one step conservative surgery. A 35year old woman G3P2A0 with 32 weeks of twin pregnancy with previous caesarean section with complaints of premature rupture of membrane was admitted in emergency labour room. Patient went into preterm labour on third day of admission and delivered two live preterm babies. Placenta could not be removed after delivery. Manual removal of placenta was tried but placenta could not be removed completely and bleeding was excessive after the procedure. Medical management of postpartum hemorrhage was done. On local examination there was no cervico-vaginal tear and laceration, upper segment of uterus appeared to be well contracted, lower segment ballooned up and bleeding was still excessive. Decision of emergency laparotomy was taken. Patient underwent emergency laparotomy for postpartum hemorrhage followed by segmental resection of invaded area, bleeding stop. Post operative period is uneventful.In young and low parity patient, one step conservative surgery can be considered a uterine preserving approach in the absence of placenta praevia.

scholarly journals Association Between Pre-delivery Coagulation Indicators and Invasive Placenta Accreta Spectrum

2022 ◽  
Vol 28 ◽  
pp. 107602962110705
Author(s):  
Zhirong Guo ◽  
Xueyan Han ◽  
Huijing Zhang ◽  
Weiran Zheng ◽  
Huixia Yang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Disease Severity ◽  
Placenta Accreta ◽  
Underlying Mechanism ◽  
Increased Risk ◽  
Invasive Placenta ◽  
Placenta Accreta Spectrum ◽  
Grade 3 ◽  
Blood Loss Volume ◽  
D Dimer

Objectives To analyze the association between pre-operational coagulation indicators and the severity of placenta accreta spectrum (PAS), as well as blood loss volume during operation. Methods Hospitalized patients of the obstetric department in a major hospital from 2018 to 2020 who were clinically and/or pathologically diagnosed with invasive PAS were included. Univariate and multivariate logistic regression and Poisson regression models were used to quantify the association between each of the 6 coagulation indicators and PAS severity (measured by FIGO grade) as well as maternal outcomes. Results Ninety-five patients (46 FIGO grade 2 and 49 FIGO grade 3) were included. Higher PT [adjusted OR (aOR): 5.54; 95% CI, 1.80 to 17.07] and FDP (aOR: 1.19; 95% CI, 1.01–1.42) levels were associated with an increased risk of FIGO grade 3 after adjusting for covariates. D-dimer [incidence rate ratio (IRR): 1.19; 95% CI, 1.05 to 1.35)] and FDP (IRR: 1.03; 95% CI, 1.01–1.04) levels were significantly associated with higher blood loss volume after adjusting for covariates. Conclusion Preoperative coagulation indicators, especially PT, D-dimer and FDP, are associated with disease severity and blood loss volume during operation of invasive PAS. The underlying mechanism for the coagulation profile of PAS patients warrants further analysis. Synopsis Preoperative coagulation indicators, especially PT, D-dimer and FDP, are associated with disease severity and blood loss volume during operation among invasive placenta accreta spectrum patients.

scholarly journals Diagnostic tests of placenta accreta index score (PAIS) as supporting prenatal diagnosis and outcomes of maternal neonatal in abnormally invasive placenta management at general hospital of Hasan Sadikin Bandung

2017 ◽  
Vol 6 (9) ◽  
pp. 3765
Author(s):  
Sefty Mariany Samosir ◽  
Setyorini Irianti ◽  
Dian Tjahyadi
Keyword(s):  
Prenatal Diagnosis ◽  
General Hospital ◽  
Maternal Death ◽  
Predictive Value ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Diagnostic Value ◽  
Caesarian Section ◽  
Invasive Placenta ◽  
Abnormally Invasive Placenta

Background: The incidence of abnormally invasive placenta increases tenfold as the number of caesarian section increases in the past 50 years. Placenta previa accreta is strongly associated with massive bleeding and leads to maternal death. Prenatal diagnosis helps in planning the delivery to reduce the risk of bleeding and possible complications. This study aims to find out diagnostic value of Placenta Accreta Index Score (PAIS) as supporting tool in prenatal diagnostic of abnormally invasive placenta.Methods: The diagnostic test was undertaken in May 2017 at General Hospital of Hasan Sadikin, identifying patients with placenta previa with history of caesarian section between May 2016-May 2017. PAIS were obtained and compared with histopathological findings.Results: Among 21 placenta previa patients with post caesarian section, 10 (47.6%) of them histopathologically proven as abnormally invasive placenta. With statistical analysis accuracy values obtained PAIS and histopathological findings in patient with placenta previa is 0.762 (good). Diagnostic value of PAIS with histopathological findings in placenta previa patient had a sensitivity 70%, a specificity 81,8%, positive predictive value (PPV) 77.8%, and negative predictive value (NPV) 75% by PAIS cut off point is 3.125. No maternal death. Mean duration of postoperative care was 5 days. Average total bleeding during surgery is 2622 ml with lowest postoperative hemoglobin 8.36g/dl. All babies born with appropriate to gestational birth weight with average first minute APGAR was 7 and without fetal anemia.Conclusions: PAIS can be used to help to predict the risk of abnormally.

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