Managements of placenta accreta

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine

Background:

• Placenta accreta is a significant obstetric complication.
• Risk factors include placenta previa and prior uterine surgery, particularly cesarean sections.

Purpose of the Study:

• To review cases of placenta accreta managed at Veterans General Hospital-Taipei.
• To analyze the incidence, risk factors, and treatment outcomes of placenta accreta.

Main Methods:

• Retrospective review of 12 placenta accreta cases from January 1986 to June 1990.
• Analysis of patient history, surgical interventions, and perinatal outcomes.
• Ultrasound for prenatal diagnosis was utilized in some cases.

Main Results:

• The incidence of placenta accreta was 1 per 1,101 deliveries (pathologically confirmed: 0.06%).
• Placenta previa and history of cesarean section were common comorbidities.
• No maternal mortality was observed; perinatal loss was minimal and attributed to immaturity.
• Accurate prenatal diagnosis was achieved in 4 cases via ultrasound.

Conclusions:

• Hysterectomy remains the definitive treatment for placenta accreta.
• Conservative management strategies should be considered as a primary approach.
• Early and accurate prenatal diagnosis using ultrasound can aid in management planning.