Abstract | INTRODUCTION: METHODS: From April 2005 to July 2019, patients with placenta increta and percreta were managed conservatively at the Kaohsiung Chang Gung Memorial Hospital in Taiwan. The severity of placenta invasion was diagnosed by magnetic resonance imaging (MRI). After delivery of the neonate, prophylactic transcatheter arterial embolization (TAE) was performed immediately. The placenta was left in situ and prophylactic antibiotics were administered during hospitalization. The patient profiles, outcomes, and complications were retrospectively reviewed. RESULTS: Based on the MRI findings, twenty-one patients with placenta increta or percreta were included. With prophylactic TAE, the mean surgical blood loss was 854.7 ± 478.2 mL. The mean natural resorption time of residual placenta was 4.69 ± 1.65 months. Regarding maternal complications, 4 patients (19%) had delayed postpartum hemorrhage (PPH), 12 patients (57.1%) developed postpartum infections, 3 patients (14.3%) progressed to sepsis, 4 patients (19%) underwent surgical evacuation, and 4 patients (19%) underwent hysterectomy. No maternal mortality was reported. Main neonatal complications were prematurity and respiratory distress. Regarding fertility, 16 (76.1%) patients had return of menstruation, and one (4.7%) had a subsequent pregnancy resulting in a live birth. DISCUSSION:
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Authors | Kun-Long Huang, Leo Leung-Chit Tsang, Yu-Fan Cheng, Fu-Jen Huang, Hung-Chun Fu, Fu-Tsai Kung, Ching-Chang Tsai, Hsin-Hsin Cheng, Yun-Ju Lai, Chia-Yu Ou, Wei-Ting Chen, Yu-Shun Tong, Yu-Chen Chen, Yu-Jen Huang, Te-Yao Hsu |
Journal | Placenta
(Placenta)
Vol. 97
Pg. 51-57
(08 2020)
ISSN: 1532-3102 [Electronic] Netherlands |
PMID | 32792063
(Publication Type: Journal Article)
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Copyright | Copyright © 2020 Elsevier Ltd. All rights reserved. |
Topics |
- Adult
- Conservative Treatment
- Embolization, Therapeutic
- Female
- Fertility Preservation
(methods)
- Humans
- Infant, Newborn
- Magnetic Resonance Imaging
- Placenta
(diagnostic imaging)
- Placenta Accreta
(diagnostic imaging, therapy)
- Pregnancy
- Retrospective Studies
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