Evaluation of three-step procedure (Shehata's technique) as a conservative management for placenta accreta at a tertiary care hospital in Egypt

Objective. - To evaluate the benefits and risks of three-step technique as a conservative treatment for women with placenta accreta and desiring future fertility. Study design. - This study is a retrospective study where the files of 91 cases of placenta accreta managed by three-step technique were reviewed. This study was conducted at Tanta University Hospitals in the period from June 1, 2015 to May 31, 2017. All demographic and operative data were extracted and recorded. Results. - The mean age was 32.44 +/- 2.72 years; the mean operative time was 81.65 +/- 15.68 min. The mean gestational age at operation was 35.67 +/- 1.19 weeks. The technique succeeded to preserve the uterus in 86 cases and failed in 5 cases. There was no cases required ICU admission with mean hospital stay of 3.065 +/- 04 days. The postoperative morbidities were mild and in the form of fever (n = 9) and wound sepsis (n = 4), pyometra (n = 1) and secondary hemorrhage (n = 1). Conclusion. - The three-step procedure is effective as a uterine sparing technique in management of placenta accreta with success rate of 94.5%. The operative and postoperative complications were minimal and expected in such case. (C) 2018 Elsevier Masson SAS. All rights reserved.