Document Detail

Caesarean section in cases of placenta praevia and accreta.
MedLine Citation:
PMID:  23127895     Owner:  NLM     Status:  Publisher    
In the past decade, the incidence of placenta praevia and placenta accreta has increased and seems to be associated with induced labour, termination of pregnancy, caesarean section and pregnancy at older age. These factors imply some degree of tissue damage, which can modify the decidualisation process, and produce excessive vascular remodelling. Placenta praevia and accreta are mainly located in the lower segment, a place that predisposes to persistent uterine bleeding because of the development of new vessels and because it is a poorly contractile area of the uterus. The complexity, determined by tissue destruction, newly formed vessels, and vascular invasion of surrounding tissues, warrants multi-disciplinary management. When resective procedures are undertaken, a suitable plan to tackle surgical problems allows better control of bleeding and avoids unnecessary hysterectomies. In cases of placenta accrete, and especially when skills or institutional resources are not available, leaving the placenta in situ may be the best option until definitive treatment is undertaken.
José M Palacios-Jaraquemada
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-2
Journal Detail:
Title:  Best practice & research. Clinical obstetrics & gynaecology     Volume:  -     ISSN:  1532-1932     ISO Abbreviation:  Best Pract Res Clin Obstet Gynaecol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101121582     Medline TA:  Best Pract Res Clin Obstet Gynaecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Ltd.
Centre for Medical Education and Clinical Research (CEMIC), Department of Gynecology and Obstetrics, Buenos Aires, Argentina; Scientific South Foundation, Lomas de Zamora, Province of Buenos Aires, Argentina; J. J. Naón Morphological Institute, School of Medicine, University of Buenos Aires, Argentina. Electronic address:
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