Delayed laparoscopic management of placenta increta

Traditional methods of management of abnormal placentation are often associated with significant maternal morbidity. In an attempt to decrease such morbidity, we present a novel approach: delayed laparoscopic management.

A patient with placenta increta was delivered by Caesarean section, followed by closure of the uterine incision, with the placenta left in situ. The patient underwent total laparoscopic hysterectomy three weeks later. She did not receive any blood product transfusions, either at the time of Caesarean section or at the time of hysterectomy.

A laparoscopic approach may be considered for delayed surgical management of abnormal placentation. Key factors for success consist of a multi-disciplinary approach, the availability of skilled laparoscopic surgeons and advanced endoscopic equipment, and the availability of resources in the event of complications.