Placenta accreta: improved maternal outcome with antenatal diagnosis and topographic assessment

Introduction: Placenta accreta is a life threatening condition associated with severe maternal haemorrhage at placental delivery. Methods: The maternal outcome was analysed in 16 cases of confirmed placenta accreta identified from our perinatal database and hospital records in 2000-6. Results: Seven women with antenatal diagnosis had Caesarean delivery, without placental separation in 5 cases of extensive accreta, and elective placental separation in 2, including I case of partial accreta. When an antenatal diagnosis was not made (n = 9), placental separation was attempted at delivery in all, resulting in a higher mean blood loss (3.6L vs. 1.4 L, p = 0.003) and emergency hysterectomy (p = 0.001). Conclusion: In extensive placenta accreta, antenatal diagnosis and topographic assessment allow avoidance of placental separation at delivery, resulting in less blood loss and improved maternal outcomes.