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Conservative surgical management of placenta accreta: a report of 3 cases
Steven Pliskow1, Xiaorong Dai, Andrew Kohner
1Department of Obstetrics and Gynecology, Palms West Hospital, 603 Village Boulevard, Suite 201, West Palm Beach, Loxahatchee, FL 33409, USA. spmlc@comcast.net
Background:
Placenta accreta is often diagnosed at the time of delivery and is a cause of postpartum hemorrhage, morbidity and mortality. The standard treatment for placenta accreta is hysterectomy to avoid acute blood loss and shock. A conservative surgical approach to the treatment of placenta accreta will allow immediate cure while preserving the patient's future fertility.
Cases:
A 39-year-old woman with placenta accreta diagnosed at the time of vaginal delivery was successfully treated with resection of the placental implantation site. A 33-year-old woman and a 35-year-old woman with placenta accreta/increta diagnosed at the time of cesarean section were successfully treated with resection of the placental implantation site. One patient has since conceived and given birth.
Conclusion:
Placenta accreta and placenta increta can be safely and successfully treated, in some well-selected cases, by resection of the placental implantation site and uterine repair. This conservative surgical management provides immediate therapy, reduces blood loss and preserves fertility.
