Conservative method in treatment of placenta accreta – two case reports

Czech version

Authors: L. Trýbová
Authors‘ workplace: Gynekologicko-porodnické oddělení Nemocnice, Jihlava přednosta prof. MUDr. A. Roztočil, CSc.
Published in: Ceska Gynekol 2012; 77(6): 548-551

Overview

Placenta accreta is an obstetric pathology with incidence around 1:
2500 deliveries. This incidence is increasing due to increasing number of caesarean sections. Hysterectomy is considered to be a standard solution in this situation. Anyway in some cases we can decide to perform a conservative way which means that uterus is saved. There are two case reports below in which we decided to proceed conservatively. We consulted the patient before doing this and in both cases we were succesful in keeping the uterus. In both cases we were able to determine diagnosis of placenta accreta up to some time after delivery. The diagnosis was made according to ultrasonography and clinical examination. We were able to manage conservative way of treatment because there were no situations that could cause an acute operating solution.

Key words:
placenta accreta, conservative treatment, hysterectomia.

Sources

1. Calda, P., Břešťák, M., Fischerová, D. Ultrazvuková diagnostika v těhotenství a gynekologii. Praha: Aprofema, 2010, s. 167.

2. Clark, SL., Koonings, PP., Phelan, JP. Placenta praevia/accreta and prior cesarean section. Obstet Gynec, 1985, 66(1), p. 89–92.

3. Courbier, B., Bretelle, F., Porcu, G., et al. Conservative treatment of placenta accreta. J Gynecol Obstet Biol Reprod, 2003, 32(6), p. 549–554.

4. Hájek, Z., et al. Rizikové a patologické těhotenství. Praha: Grada Publishing, 2004, s. 367–368.

5. Levine, D., Hulka, CA., Ludmil, J., et al. Placenta accreta: evaluation with color Doppler US, power Doppler US and MR paging. Radiology, 1997, 205, p. 773–776.

6. Miller, DA., Chollet, JA., Goodwin, TM. Clinical risk factors for placenta previa – placenta accreta, Am J Obstet Gynecol, 1997, 177, p. 210–214.

7. Roztočil, A., et al. Moderní porodnictví. Praha: Grada Publishing, 2008, 298 s.