TY - JOUR
T1 - The morbidly adherent placenta
T2 - An overview of management options
AU - Doumouchtsis, Stergios K.
AU - Arulkumaran, Sabaratnam
PY - 2010
Y1 - 2010
N2 - Morbidly adherent placenta is often associated with severe maternal morbidity. An increased incidence over the recent years may be secondary to the increased cesarean section rates. Identification of patients with risk factors antenatally is essential for the early diagnosis and management. Diagnosis can be achieved by ultrasound or MRI in the majority of cases. Management aims to ensure a safe delivery of the fetus, alongside measures of prevention or effective management of postpartum hemorrhage. When a hysterectomy is performed, a multidisciplinary team with surgical expertise and facilities for transfusion and further interventions including arterial ligation and interventional radiology should be available. The options for conservative treatments offer the potential to preserve fertility but further research with prospective evaluation of the different approaches is necessary.
AB - Morbidly adherent placenta is often associated with severe maternal morbidity. An increased incidence over the recent years may be secondary to the increased cesarean section rates. Identification of patients with risk factors antenatally is essential for the early diagnosis and management. Diagnosis can be achieved by ultrasound or MRI in the majority of cases. Management aims to ensure a safe delivery of the fetus, alongside measures of prevention or effective management of postpartum hemorrhage. When a hysterectomy is performed, a multidisciplinary team with surgical expertise and facilities for transfusion and further interventions including arterial ligation and interventional radiology should be available. The options for conservative treatments offer the potential to preserve fertility but further research with prospective evaluation of the different approaches is necessary.
KW - Accreta
KW - Diagnosis
KW - Increta
KW - Management
KW - Morbidly adherent placenta
KW - Percreta
UR - http://www.scopus.com/inward/record.url?scp=77956333243&partnerID=8YFLogxK
U2 - 10.3109/00016349.2010.503869
DO - 10.3109/00016349.2010.503869
M3 - Review article
C2 - 20804337
AN - SCOPUS:77956333243
SN - 0001-6349
VL - 89
SP - 1126
EP - 1133
JO - Acta Obstetricia et Gynecologica Scandinavica
JF - Acta Obstetricia et Gynecologica Scandinavica
IS - 9
ER -