1/37. creatine kinase as a biochemical marker in diagnosis of placenta increta and percreta.We describe 1 case of placenta increta and 1 of placenta percreta, both associated with elevated maternal serum creatine kinase concentration. In patients with placenta previa and ultrasonographic findings of an abnormally adherent placenta, an unexplained elevation in maternal serum creatine kinase level should alert the clinician to the possibility of placenta increta or placenta percreta, with an attendant increase in maternal morbidity.- - - - - - - - - - ranking = 1keywords = previa (Clic here for more details about this article) |
2/37. Placenta percreta: report of a case.placenta accreta, increta, or percreta are rare but potentially lethal obstetric emergencies. Removal of abnormal growth of the placenta into the uterine wall is difficult or impossible and results in massive blood loss. hysterectomy may be necessary to save the mother's life. The common predisposing factors in development of placenta percreta are repeat cesarean and placenta previa. The diagnosis of placenta percreta may remain undiagnosed until delivery. The case presented describes a scenario involving placenta percreta with bladder involvement in which the diagnosis was known in advance. The article describes the preoperative preparation, intraoperative events, and postoperative status of this particular case.- - - - - - - - - - ranking = 1keywords = previa (Clic here for more details about this article) |
3/37. placenta accreta/increta. review of 10 cases and a case report.A review of the patients seen at the Department of obstetrics at Dokkyo University Hospital who had suffered placenta accreta/increta in the past 18 years, was performed. There were 10 such cases out of 9,716 deliveries during this period. This incidence is higher than that which has been reported in other Western countries. Forty percent of the patients in our study had placenta accreta/increta accompanied by placenta previa or low lying; 30% had had a prior cesarean section (C/S); 70% had previously experienced dilatation and curettage (D & C); 80% had previously undergone a C/S and/or D & C: and 40% had a history of miscarriage. Three of the ten patients with placenta accreta/increta required a hysterectomy; 2 patients were successfully treated with hemostatic stitches on the endometrium; and the remaining 5 mild cases were treated with removal of the placenta, either manually or with the use of forceps. There was no case of maternal death. In 2 cases, neonatal asphyxia was noted, but the neonate immediately recovered.- - - - - - - - - - ranking = 1keywords = previa (Clic here for more details about this article) |
4/37. placenta accreta and methotrexate therapy: three case reports.placenta accreta is a complication that is rising in incidence. The reported experience of methotrexate treatment in the conservative management of placenta accreta is scant. Three cases of placenta accreta managed with methotrexate are presented. Case 1: A woman had an antenatal diagnosis of placenta percreta. A successful manual placental removal occurred on post-cesarean day 16. Case 2: A woman had retention of a placenta accreta after a term vaginal delivery. Successful dilation and curettage were performed on postpartum day 37. Case 3: A woman had an antenatal diagnosis of placenta previa-percreta with bladder invasion. A simple hysterectomy was performed on post-cesarean day 46. Conservative management and methotrexate treatment resulted in uterine preservation in two of our three patients; however, this treatment did not prevent significant delayed hemorrhage. In view of the rapid resolution of vascular invasion of the bladder, methotrexate may have an important role in the management of placenta percreta with bladder invasion. The utility of methotrexate treatment with the conservative management of placenta accreta requires further evaluation.- - - - - - - - - - ranking = 1keywords = previa (Clic here for more details about this article) |
5/37. Normovolemic hemodilution before cesarean hysterectomy for placenta percreta.BACKGROUND: Placenta percreta can create life-threatening hemorrhage at the time of delivery. The additional challenge of patient refusal of blood transfusion for religious reasons requires the use of comprehensive blood-conserving strategies. CASE: A Jehovah's Witness with two previous cesarean deliveries and a placenta previa was diagnosed antenatally as having placenta percreta. Acute normovolemic hemodilution was performed in conjunction with cesarean hysterectomy with no maternal or fetal side effects. CONCLUSION: Acute normovolemic hemodilution can be used safely in the pregnant woman at high risk for excessive intraoperative blood loss and should be considered in obstetric patients who strictly adhere to religious convictions prohibiting the acceptance of blood products.- - - - - - - - - - ranking = 1keywords = previa (Clic here for more details about this article) |
6/37. argon beam coagulation facilitates management of placenta percreta with bladder invasion.BACKGROUND: Placenta percreta with bladder invasion is a rare but potentially lethal complication of pregnancy. CASE: A multigravida, with a history of two prior cesarean deliveries, presented with complaints of heavy vaginal bleeding near term. She had been previously diagnosed with an anterior placenta previa. A placenta percreta with bladder invasion was confirmed on cystoscopy. The patient underwent a successful cesarean hysterectomy using the argon beam coagulator. CONCLUSION: argon beam coagulation may successfully help manage placenta percreta with bladder invasion while minimizing blood loss.- - - - - - - - - - ranking = 1keywords = previa (Clic here for more details about this article) |
7/37. Antepartum diagnosis of placenta previa percreta by magnetic resonance imaging.BACKGROUND: placenta previa percreta is a rare but highly morbid condition usually diagnosed intraoperatively. Placental manipulation results in severe bleeding. magnetic resonance imaging (MRI) might allow antepartum diagnosis of this condition. CASE: A multiparous woman with five previous abdominal deliveries had complete placenta previa diagnosed at 16 weeks' gestation. Bleeding ensured at 29 weeks and she was managed with bed rest. Before planned abdominal delivery, MRI was performed and placenta percreta was diagnosed, which allowed her physician to avoid placental manipulation. hysterectomy was accomplished with an estimated blood loss of only 2000 mL. CONCLUSION: Antepartum diagnosis of placenta previa percreta by MRI altered the usual diagnostic and surgical approach, diminishing blood loss and morbidity.- - - - - - - - - - ranking = 7keywords = previa (Clic here for more details about this article) |
8/37. Placenta percreta with urinary bladder involvement.A 37-year-old Pakistani lady, who had previously undergone one cesarean delivery and one uterine curettage, was admitted to the labor ward at 29 weeks of gestation with history of a sudden severe painless vaginal bleeding from a sonographically diagnosed placenta previa. An immediate cesarean section was performed and a live male infant was delivered. The placenta was morbidly adherent to the lower uterine segment and attempts at removal caused torrential bleeding, necessitating cesarean hysterectomy. In addition, attempts to dissect the bladder from the lower uterine segment were unsuccessful and, hence, the diagnosis of placenta percreta with involvement of the urinary bladder was made. A modified posterior approach to the hysterectomy was carried out, with subsequent good recovery.- - - - - - - - - - ranking = 1keywords = previa (Clic here for more details about this article) |
9/37. Gravid uterus exteriorization at cesarean delivery for prenatally diagnosed placenta previa-accreta.Uterine exteriorization during fetal surgery permits hysterotomy away from anterior placental implantations. We employed this technique in two cesarean deliveries for anterior placenta previa-accreta, facilitating selective uterine incisions. Exteriorization of the near-term gravid uterus may be a useful adjunct to cesarean delivery for anterior placenta previa-accreta.- - - - - - - - - - ranking = 6keywords = previa (Clic here for more details about this article) |
10/37. prenatal diagnosis of placenta accreta and percreta with ultrasonography, color Doppler, and magnetic resonance imaging.BACKGROUND: The risk of placenta previa and accreta is increased in females with previous cesarean deliveries, and there has been an increasing number of these operations. CASES: We present 2 cases with previous cesarean and placenta previa in the following pregnancy. One patient had placenta accreta and the other, placenta percreta. In both cases, prenatal diagnosis was based on ultrasonography, where features such as loss of the hypoechoic retroplacental zone and irregular uterine serosa were found in grayscale ultrasonography. In color Doppler imaging, in both cases, increased vascularity between myometrium and placenta, as well as intraplacental lacunae, were seen. Thinning of the uterine wall, found in magnetic resonance imaging, contributed to the diagnosis of placenta percreta. CONCLUSION: prenatal diagnosis of placenta accreta is of importance because it reduces fetal and maternal morbidity as appropriate preoperative and perioperative procedures are possible.- - - - - - - - - - ranking = 2keywords = previa (Clic here for more details about this article) |
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