Journal
OBSTETRICS AND GYNECOLOGY CLINICS OF NORTH AMERICA
Volume 42, Issue 2, Pages 381-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.ogc.2015.01.014
Keywords
Abnormal placentation; Accreta; Increta; Percreta; Placenta; Hemorrhage; Cesarean hysterectomy; Indicated preterm delivery
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Placenta accreta can lead to hemorrhage, resulting in hysterectomy, blood transfusion, multiple organ failure, and death. Accreta has been increasing steadily in incidence owing to an increase in the cesarean delivery rate. Major risk factors are placenta previa in women with prior cesarean deliveries. Obstetric ultrasonography can be used to diagnose placenta accreta antenatally, which allows for scheduled delivery in a multidisciplinary center of excellence for accreta. Controversies exist regarding optimal management, including optimal timing of delivery, surgical approach, use of adjunctive measures, and conservative (uterine-sparing) therapy. We review the definition, risk factors, diagnosis, management, and controversies regarding placenta accreta.
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