Document Detail


Fertility and obstetric outcome after conservative management of placenta accreta.
MedLine Citation:
PMID:  20152971     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the fertility and obstetric outcomes after conservative management of placenta accreta. METHODS: A retrospective observational cohort study of all identified cases of placenta accreta from 1993 to 2007 in 2 tertiary university hospitals in France. For patients treated conservatively, maternal and fetal morbidity, reproductive function, fertility, and subsequent pregnancies were recorded. RESULTS: During the study period, 46 patients were treated by conservative management; 6 patients underwent a secondary hysterectomy. Of the remaining 40 patients, 35 were followed up for a median of 65 months (range 18-156 months). Patients resumed their menstrual cycles after a median of 130 days (range 48-176 days). Menses were irregular in 11 patients (31%), but none had amenorrhea. Twelve of the 14 patients desiring another pregnancy achieved a total of 15 pregnancies; 2 patients had recurrent placenta accreta. Five spontaneous abortions and 1 termination of pregnancy occurred during the first trimester. The median term at delivery was 37 weeks (range, 35-40 weeks). Four patients delivered prematurely. CONCLUSION: Conservative management of placenta accreta can preserve fertility, although the risk of recurrent placenta accreta appears to be high.
Authors:
Magali Provansal; Blandine Courbiere; Aubert Agostini; Claude D'Ercole; Léon Boubli; Florence Bretelle
Publication Detail:
Type:  Journal Article     Date:  2010-02-12
Journal Detail:
Title:  International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics     Volume:  109     ISSN:  1879-3479     ISO Abbreviation:  Int J Gynaecol Obstet     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-13     Completed Date:  2010-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0210174     Medline TA:  Int J Gynaecol Obstet     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  147-50     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Obstetrics and Gynecology, La Conception University Hospital, Marseille, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cesarean Section / adverse effects
Cohort Studies
Female
Fertility*
France / epidemiology
Hospitals, University
Humans
Hysterectomy / adverse effects
Infertility, Female / etiology,  prevention & control*
Menstruation
Placenta Accreta / etiology,  therapy*
Pregnancy
Retrospective Studies
Treatment Outcome
Young Adult

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