scholarly journals Conservative Management of Abnormally Invasive Placenta Previa after Midtrimester Foetal Demise

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
A. MacGibbon ◽  
Y. M. Ius
Keyword(s):  
Fertility Preservation ◽  
Conservative Management ◽  
Surgical Intervention ◽  
Placenta Previa ◽  
Placenta Increta ◽  
Significant Complication ◽  
Obstetric Haemorrhage ◽  
Invasive Placenta ◽  
Abnormally Invasive Placenta

We present the case of a midtrimester intrauterine foetal demise (IUFD) in the context of abnormally invasive placentation. This was a grade 4 placenta previa with placenta increta in a patient requesting fertility conservation and was managed conservatively without immediate surgical intervention. The patient spontaneously delivered the fetus after 33 days, followed by a large obstetric haemorrhage requiring immediate laparotomy and hysterotomy. Her uterus was preserved and she went on to recover without further significant complication. While conservative management of morbidly adherent placentas has been well documented, there are no published cases of this strategy in the context of IUFD and fertility preservation.

scholarly journals Conservative management of abnormally invasive placenta: four case reports

2013 ◽  
Vol 92 (4) ◽  
pp. 468-471 ◽  
Author(s):  
Angela Ramoni ◽  
Eva-Maria Strobl ◽  
Johanna Tiechl ◽  
Magdalena Ritter ◽  
Christian Marth
Keyword(s):  
Conservative Management ◽  
Case Reports ◽  
Invasive Placenta ◽  
Abnormally Invasive Placenta

Innovation of delivery of pregnant women with abnormally invasive placenta: placenta percreta (Case of practice)

2018 ◽  
pp. 19-24
Author(s):  
O.V. Golyanovskiy ◽  
◽  
V.V. Mekhedko ◽  
D.O. Goncharenko ◽  
V.M. Kucher ◽  
...  
Keyword(s):  
Placenta Previa ◽  
Argon Plasma ◽  
Placental Tissue ◽  
Massive Bleeding ◽  
Balloon Occlusion ◽  
Depth Of Invasion ◽  
Internal Iliac ◽  
Invasive Placenta ◽  
Severe Pathology ◽  
Abnormally Invasive Placenta

The article presents a case from practice with prenatal diagnostics of abnormally invasive placenta (Рl. Percreta) with invasion into the back wall of the bladder on the background of full placenta previa and previous caesarean section. Stressed the relevance of modern diagnostic pathologists placentation using ultrasound, Doppler and MRI to determine the depth of invasion of the placental tissue into the myometrium is emphasized. An innovative algorithm for delivery of a pregnant woman with this severe pathology using the endovascular technique of temporary balloon occlusion of the abdominal aorta, performing a cesarean section with a subsequent hysterectomy without appendages, ligating of the internal iliac arteries (IIAL), and argon-plasma tissue coagulation is proposed. The proposed method significantly reduces the amount of blood loss, the likelihood of developing massive bleeding, coagulopathic disorders and possible damage to adjacent organs. Key words: abnormally invasive placenta, placenta increta/rercreta, placenta previa, massive obstetric hemorrhage, balloon occlusion of the aorta, argon-plasma tissue coagulation.

3D power Doppler in the evaluation of abnormally invasive placenta

2017 ◽  
Vol 45 (6) ◽  
Author(s):  
Giuseppe Calì ◽  
Francesca Foti ◽  
Gabriella Minneci
Keyword(s):  
Gold Standard ◽  
Placenta Previa ◽  
Power Doppler ◽  
Three Dimensional ◽  
Diagnostic Techniques ◽  
3D Power Doppler ◽  
Invasive Placenta ◽  
2D Ultrasound ◽  
Abnormally Invasive Placenta ◽  
Bladder Invasion

AbstractThe anomalies in placental insertion and invasion, such as placenta previa and the various forms of abnormally invasive placenta, are today a rising obstetric pathology. Two-dimensional (2D) ultrasonography is the gold standard in the diagnosis of abnormally invasive placenta (AIP), but the important feto-maternal impact of this pathology suggests the opportunity to employ all the available diagnostic techniques, such as three-dimensional (3D) power Doppler. This technique allows acquiring multiplanar images on coronal, axial and sagittal planes and with a rotational technique, it permits visualizing the placenta-bladder interface more accurately. Consequently, it allows a better study of the degree of bladder invasion, which is information that has a great impact on the subsequent counseling and management. Thus, 3D power Doppler represents an important technique complementary to 2D ultrasound in the diagnosis of AIP. The aim of this paper is to illustrate the possible applications of this procedure, referring to the main literature data.

scholarly journals Maternal outcome after conservative management of abnormally invasive placenta

2017 ◽  
Vol 56 (3) ◽  
pp. 353-357 ◽  
Author(s):  
Hsiu-Wei Su ◽  
Yu-Chiao Yi ◽  
Jenn-Jhy Tseng ◽  
Wei-Chih Chen ◽  
Ya-Fang Chen ◽  
...  
Keyword(s):  
Conservative Management ◽  
Maternal Outcome ◽  
Invasive Placenta ◽  
Abnormally Invasive Placenta

scholarly journals Abnormally invasive placenta: an overview of diagnosis and management options

2017 ◽  
Vol 6 (11) ◽  
pp. 5013
Author(s):  
Parveen Rajora ◽  
Amanjot Singh
Keyword(s):  
Placenta Previa ◽  
Management Options ◽  
Diagnosis And Management ◽  
Medical College ◽  
Uterine Surgery ◽  
Broad Term ◽  
Invasive Placenta ◽  
Life Threatening ◽  
Foetal Outcome ◽  
Abnormally Invasive Placenta

Background: Abnormally invasive placenta, also known as morbidly adherent placenta, is a broad term that describes abnormal adherence of placenta to the underlying myometrium. Clinical risk factors include placenta previa and prior uterine surgery, including caesarean delivery. The diagnosis and management of women at risk is not only based on clinical parameters, but also driven by imaging, namely ultrasound and more recently magnetic resonance (MRI) imaging.Methods: This is a retrospective analysis of 10 cases of abnormally invasive placenta undertaken at Guru Gobind Singh Medical College and Hospital, Faridkot.Results: Hysterectomy done in six cases and uterus was preserved in four cases. Foetal outcome was on average side. Four foetal losses noted two because of prematurity and two due to excessive blood loss admitted with intra uterine foetal death. Two babies needed NICU care but successfully discharged.Conclusions: Newer approaches should be considered investigational until larger prospective series to become available, until then hysterectomy should remain the stay of treatment specially when the family is complete and there is life threatening Haemorrhage.

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