PATHOLOGICAL ADHERENCE OF PLACENTA - CASE REPORTS
R Sulukhia1, L Melia1, N Pirtskhalava1
1Acad. O. Gudushauri National Medical Center, Perinatal Department, Tbilisi, Georgia.
Georgian Medical News
|August 19, 2017
Summary
Major obstetric hemorrhage, a leading cause of maternal death, can stem from abnormal placental adherence. Early diagnosis and a multidisciplinary approach are crucial for managing severe cases, especially placenta percreta involving the bladder.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Surgical Management
Background:
- Major obstetric hemorrhage is a primary cause of maternal morbidity and mortality.
- Abnormal placentation, including placenta accreta, increta, and percreta, presents a significant risk.
- Risk factors include placenta previa with uterine scarring, increasing cesarean rates, and advanced maternal age.
Observation:
- The incidence of abnormal placentation has risen significantly, from 1 in 2,500 to 1 in 533 deliveries.
- Placenta percreta poses substantial risks to both mother and fetus.
- Bladder invasion by the placenta leads to high maternal morbidity (9.5%) and perinatal mortality (24%).
Findings:
- Adequate preoperative diagnostics are essential for preventing maternal deaths in patients with uterine scarring or prior invasive procedures.
- A multidisciplinary team approach involving urology, radiology, and obstetrics-gynecology is critical for managing placenta percreta with bladder involvement.
Implications:
- Improved diagnostic strategies can enhance maternal outcomes in high-risk pregnancies.
- Multidisciplinary care is vital for optimizing management of complex placental abnormalities.
- Further research into prevention and early detection of abnormal placentation is warranted.
