Conservative management of placenta previa complicated by abnormal placentation

被引：6

作者：

Breborowicz, Grzegorz H. ^{[1
]}

Markwitz, Wieslaw ^{[1
]}

Gaca, Michal ^{[2
]}

Koziolek, Agnieszka ^{[2
]}

Ropacka-Lesiak, Mariola ^{[1
]}

Dera, Anna ^{[1
]}

Brych, Mariusz ^{[3
]}

Szymankiewicz-Breborowicz, Marta ^{[4
]}

Kruszynski, Grzegorz ^{[1
]}

Gruca-Stryjak, Karolina ^{[1
]}

Madejczyk, Mateusz ^{[1
]}

Szpera-Gozdziewicz, Agata ^{[1
]}

Krzyscin, Mariola ^{[1
]}

机构：

[1] Poznan Univ Med Sci, Dept Perinatol & Gynecol, PL-60535 Poznan, Poland

[2] Poznan Univ Med Sci, Dept Anesthesiol Obstet & Gynecol, PL-60535 Poznan, Poland

[3] Dist Hosp, Dept Obstet & Gynecol, Gorzow Wielkopolski, Poland

[4] Poznan Univ Med Sci, Dept Neonatol, PL-60535 Poznan, Poland

来源：

JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE | 2013年 / 26卷 / 10期

关键词：

Conservative management; fertility; invasion of placenta; maternal morbidity; placenta previa; ADHERENT PLACENTA; ACCRETA; PREDICTION; DIAGNOSIS; PERCRETA;

D O I：

10.3109/14767058.2013.766708

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Objective: Abnormal implantation of placenta previa is life-threatening condition. The purpose of this study was to evaluate the impact of the conservative management of pregnancies with such complication on maternal morbidity rate and the chance for uterine preservation (fertility). Methods: Eleven patients with abnormal implantation of placenta previa were analyzed prospectively. This complication was diagnosed antenatally by two-dimensional ultrasound and color flow Doppler. The following outcomes were analyzed: need for blood transfusion, admission and duration of stay in intensive care unit, infections, coagulopathies, time between cesarean section and delivery of placenta, hysterectomy and preservation of uterus. Results: Among the 20 085 women who had a singleton gestation, 11 (0.054%) were identified with placenta previa with abnormal placentation. In five patients (group A), hysterectomy was performed because of hemorrhage or placenta ablation. In six patients (group B), conservative management succeeded and placenta were preserved. In group A, placenta were delivered earlier (2 d-8 weeks) in comparison with group B (6-15 weeks). Estimated blood loss during the delayed delivery of placenta was higher in the group with hysterectomy (respectively, 450-1600 and 300-500 ml). Conclusions: Conservative management of placenta previa with abnormal implantation decreases the risk of severe hemorrhage at the time of delivery and can preserve fertility.

引用

页码：1012 / 1015

页数：4