Document Detail


Conservative management of placenta previa complicated by abnormal placentation.
MedLine Citation:
PMID:  23350544     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract 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 5 patients (group A) hysterectomy was performed because of hemorrhage or placenta ablation. In 6 patients (group B) conservative management succeeded and placentae were preserved. In group A placentae were delivered earlier (2 days - 8 weeks) in comparison with group B (6 - 15 weeks). Estimated blood loss during the delayed delivery of placentae was higher in the group with hysterectomy (respectively (450 - 1600 ml 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.
Authors:
Grzegorz H Bręborowicz; Wiesław Markwitz; Michał Gaca; Agnieszka Koziołek; Mariola Ropacka-Lesiak; Anna Dera; Mariusz Brych; Marta Szymankiewicz-Bręborowicz; Grzegorz Kruszyński; Karolina Gruca-Stryjak; Mateusz Madejczyk; Agata Szpera-Goździewicz; Mariola Krzyścin
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-28
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Perinatology and Gynecology, Poznan University of Medical Sciences, 33 Polna, Poznań, Poland.
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