Related Experiment Video
Updated: Jun 25, 2026
04:08
Mouse Model of Surgical Uterine Injury and Subsequent Pregnancy Outcomes
Published on: June 27, 2025
Optimal management strategies for placenta accreta
A G Eller1, T F Porter, P Soisson
1Department of Obstetrics and Gynecology, Divisions of Maternal Fetal Medicine and Gynecologic Oncology, University of Utah, Salt Lake City, UT 84132, USA. lexigrosvenor@gmail.com
BJOG : an International Journal of Obstetrics and Gynaecology
|February 5, 2009
Summary
Managing placenta accreta with scheduled hysterectomy and ureteric stents, avoiding placental removal, significantly reduces maternal morbidity. This approach improves outcomes for women with suspected placenta accreta.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Surgical Management of Pregnancy Complications
Background:
- Placenta accreta presents significant risks for maternal morbidity and mortality.
- Effective management strategies are crucial to minimize complications during delivery.
Purpose of the Study:
- To identify interventions for placenta accreta management that reduce maternal morbidity.
- To compare outcomes based on specific surgical and preoperative approaches.
Main Methods:
- Retrospective cohort study of 76 placenta accreta cases (1996-2008) at two tertiary hospitals.
- Analysis of maternal complications related to antenatal suspicion, delivery indications, preoperative preparation, placental removal attempts, and hypogastric artery ligation.
Main Results:
- Scheduled cesarean hysterectomy without attempted placental removal significantly reduced early morbidity (36% vs. 67%, P=0.038).
- Preoperative bilateral ureteric stent placement was associated with lower early morbidity (18% vs. 55%, P=0.018).
- Hypogastric artery ligation did not demonstrate a reduction in maternal morbidity.
Conclusions:
- Scheduled cesarean hysterectomy with preoperative ureteric stent placement is associated with reduced maternal morbidity.
- Avoiding attempted placental removal during hysterectomy for suspected placenta accreta improves patient outcomes.
- These interventions represent key strategies for optimizing the management of placenta accreta.
