Conservative management of placenta percreta: a stepwise approach

Arch Gynecol Obstet. 2015 May;291(5):993-8. doi: 10.1007/s00404-014-3496-x. Epub 2014 Oct 7.

Abstract

Purpose: To describe a modified surgical approach in the form of stepwise cesarean section in placenta percreta.

Methods: We conducted a prospective observational study. A total of 71 patients with placenta percreta were subjected to the new stepwise surgical approach and uterine repair at the time of cesarean delivery.

Results: The procedure was successful in controlling the bleeding and preserving the patient's uterus in 65 (91.5%) women. Ten patients (14.1%) had urinary tract complications, nine (90%) were managed during cesarean section and one presented late in the form of vesicouterine fistula.

Conclusions: A stepwise cesarean section is safe and effective procedure that can be applied in placenta percreta.

Publication types

  • Evaluation Study
  • Observational Study

MeSH terms

  • Adult
  • Blood Loss, Surgical / prevention & control*
  • Cesarean Section / adverse effects*
  • Female
  • Fistula / etiology
  • Humans
  • Magnetic Resonance Imaging
  • Placenta Accreta / surgery*
  • Postpartum Hemorrhage / surgery
  • Pregnancy
  • Pregnancy Trimester, Third
  • Prospective Studies
  • Treatment Outcome
  • Ultrasonography, Doppler, Color
  • Uterus / surgery*