scholarly journals A case series on conservative management in pregnancies with abnormal placentation in obstetrics: placenta accrete, increta and percreta

2018 ◽  
Vol 7 (12) ◽  
pp. 5193
Author(s):  
Fasiha Tasneem ◽  
Vijayalakshmi Shanbhag
Keyword(s):  
Conservative Management ◽  
Placenta Accreta ◽  
Post Partum ◽  
Case Series ◽  
Chemotherapeutic Agents ◽  
Morbidly Adherent Placenta ◽  
Decidua Basalis ◽  
Adherent Placenta ◽  
Caesarean Delivery Rate

Adherent placenta is one of the important causes of post- partum hemorrhage. Placenta accreta-related pathologies are an increasing contributor to maternal death from hemorrhage. With the rising caesarean delivery rate the incidence of placenta accreta has significantly increased. Morbidly adherent placenta (MAP) occurs when there is a defect in the decidua basalis, resulting in an abnormal invasion of the placenta into the substance of the uterus. A multidisciplinary approach is relevant in managing these patients in order to reduce morbidity and mortality associated with morbidly adherent placenta. A non-surgical conservative method is to leave the placenta in situ to reabsorb and institute treatment with chemotherapeutic agents, such as methotrexate. With improvement in the medical services conservative management for adherent placenta has gained significance.

Morbidly Adherent Placenta managed Conservatively: A Case Series

2016 ◽  
Vol 8 (4) ◽  
pp. 327-330
Author(s):  
Ramiti Gupta ◽  
Beant Singh ◽  
Balwinder Kaur ◽  
Manjit K Mohi
Keyword(s):  
South Asian ◽  
Placenta Accreta ◽  
Case Series ◽  
Peripartum Hysterectomy ◽  
Morbidly Adherent Placenta ◽  
Retained Placenta ◽  
Adherent Placenta ◽  
Future Fertility

ABSTRACT Placenta accreta refers to any abnormally invasive placental implantation. Diagnosis is suspected postpartum with failed delivery of a retained placenta. Massive obstetrical hemorrhage is a known complication often requiring peripartum hysterectomy. We report a series of cases of placenta accreta in patients desiring future fertility who were managed conservatively. How to cite this article Kaur B, Mohi MK, Singh B, Gupta R. Morbidly Adherent Placenta managed conservatively: A Case Series. J South Asian Feder Obst Gynae 2016;8(4):327-330.

scholarly journals 367: Validation of the placenta accreta index to predict morbidly adherent placenta

2017 ◽  
Vol 216 (1) ◽  
pp. S222
Author(s):  
Sarah K. Happe ◽  
C. Edward Wells ◽  
Jodi S. Dashe ◽  
Martha W.F. Rac ◽  
Donald D. McIntire ◽  
...  
Keyword(s):  
Placenta Accreta ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta

scholarly journals Case series of pubic bone diastasis causing severe pelvic girdle pain in pregnancy

2019 ◽  
Vol 8 (11) ◽  
pp. 4612
Author(s):  
Pooja Gupta ◽  
Renuka Malik
Keyword(s):  
Conservative Management ◽  
Post Partum ◽  
Treatment Guideline ◽  
Case Series ◽  
Pelvic Girdle ◽  
Pelvic Girdle Pain ◽  
Treatment Modalities ◽  
Pubic Bone ◽  
X Rays ◽  
Pubic Symphysis Diastasis

Pelvic girdle pain (PGP) is a pregnancy discomfort that causes pain and limitation of mobility and functioning in any of the three pelvic joints. The patient usually presents antenatally with persistent suprapubic pain which is exaggerated during moving, walking or climbing stairs. Intrapartum, this could be associated with disruption of sacroiliac joint, hematuria and bladder dysfunction in severe cases. Pelvic X-rays, ultrasound, and magnetic resonance imaging aid in confirmation of diagnosis by measuring the degree of separation of symphysis. Treatment modalities range from conservative management to orthopedic interventions in form of pelvic strapping, open reduction and internal fixation. Postpartum pain often masks clinicians to make the diagnosis of pubic symphysis diastasis. A case series of three cases which were diagnosed and confirmed with ultrasound and managed with orthopedic consultation. till their delivery and in post-partum period till recovery. Although there is still no specific consensus on treatment guideline, management generally of conservative management to surgical in the form of pelvic bracing or strapping. Awareness of this rare condition can help in management of pain and associated disability which improves post-delivery.

Expectant management of retained abnormally adherent placenta complicated by uterine prolapse after vaginal delivery

2020 ◽  
Vol 50 (2) ◽  
pp. 160-162
Author(s):  
Nnabuike C Ngene ◽  
Amon Siveregi
Keyword(s):  
Vaginal Delivery ◽  
Placenta Accreta ◽  
Uterine Prolapse ◽  
Expectant Management ◽  
Middle Income ◽  
Middle Income Countries ◽  
Adherent Placenta ◽  
Prenatal Imaging ◽  
Placenta Accreta Spectrum

The placenta accreta spectrum (PAS) describes invasion and adherence of the placenta onto or beyond the myometrium. Prenatal imaging improves management outcomes. In low- and middle-income countries (LMIC), however, the unavailability of ultrasonography in some health facilities delays the diagnosis, particularly if the prenatal period is asymptomatic. Following vaginal delivery, it often manifests as failure to remove a retained placenta manually. In the absence of haemorrhage, expectant management involving leaving the placenta in situ, is an option. In the presence of haemorrhage and/or sepsis, hysterectomy is usually recommended. We present a case of an expectantly managed PAS following a spontaneous preterm vaginal birth. The patient developed puerperal uterine prolapse with the placenta in situ, a previously unreported complication, but this was successfully reduced manually.

scholarly journals ElNoury - Webster bundle: a pre-emptive surgical approach for the management of morbidly low or adherent placenta

2020 ◽  
Author(s):  
Amr Elnouri ◽  
Dr Sophia Webster ◽  
Diaa Abdelhalim
Keyword(s):  
Placenta Accreta ◽  
Case Series ◽  
Placenta Praevia ◽  
Uterine Preservation ◽  
Healthcare Settings ◽  
Adherent Placenta ◽  
Obstetric Haemorrhage ◽  
Maternal Morbidity And Mortality ◽  
Placenta Accreta Spectrum ◽  
Caesarean Hysterectomy

Placenta accreta spectrum and placenta praevia are a significant cause of obstetric haemorrhage, maternal morbidity and mortality worldwide. We report a novel surgical technique, which pre-emptively and prophylactically reduces intrapartum bleeding during caesarean sections for these conditions and hence reducing the risk for a caesarean hysterectomy. This technique is particularly useful in low resource healthcare settings where interventional radiology is not readily available and where the woman is keen on uterine preservation. In this report we present the surgical and clinical outcomes of a case series of 16 patients on whom this technique was piloted demonstrating its feasibility and safety.

scholarly journals Conservative management options for morbidly adherent placenta

2017 ◽  
Vol 6 (3) ◽  
pp. 1057
Author(s):  
Meena N. Satia ◽  
Animesh Gandhi ◽  
Manali P. Shilotri
Keyword(s):  
Caesarean Section ◽  
Conservative Management ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Care Hospital ◽  
Management Options ◽  
Morbidly Adherent Placenta ◽  
Balloon Catheters ◽  
Adherent Placenta ◽  
Internal Iliac

Background: Morbidly adherent placenta is still a very significant cause of obstetric hemorrhage.Methods: A retrospective, descriptive study was undertaken over a period of one and a half year in a tertiary care hospital of all diagnosed cases of morbidly adherent placenta which were managed conservatively and the maternal and perinatal outcomes were noted. Preparation for conservative management of cases of adherent placenta in the antenatal period included informing interventional radiologists and placement of internal iliac balloon catheters just before classical caesarean section. Post-operative methotrexate was used in a few patients.Results: 11 cases of morbidly adherent placenta diagnosed on Doppler ultrasound scan, and confirmed by MRI were identified. All patients underwent classical caesarean section. 9 patients had internal iliac balloon placement. 5 patients received methotrexate. 3 patients required obstetric hysterectomy. 1 maternal and 2 perinatal mortalities were noted.Conclusions: Interventional radiology and methotrexate can be used to avoid peripartum hysterectomy and to optimize maternal and perinatal outcome.

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