Cases reported "Placenta Accreta"

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1/21. 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.
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keywords = blood loss
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2/21. Prophylactic perioperative hypogastric artery balloon occlusion in abnormal placentation.

    OBJECTIVE: The aim of this paper is to describe and evaluate the technique of prophylactic balloon occlusion of hypogastric arteries in abnormal placentation. Five patients with suspected placenta accreta, placenta percreta, or placenta increta underwent perioperative balloon occlusion of hypogastric arteries after classic cesarean delivery and before hysterectomy with hypogastric artery ligation. Two patients did not require transfusions; of the three who did, the estimated blood loss ranged from 1100 to 4000 mL. CONCLUSION: We conclude that balloon occlusion of the hypogastric arteries is a safe and effective adjunct to cesarean hysterectomy in an attempt to minimize blood loss in patients with abnormal placentation.
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keywords = blood loss
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3/21. Expectant management of placenta accreta following stillbirth at term: a case report.

    placenta accreta is a rare complication of pregnancy with high rates of morbidity and mortality. We report a case of expectant management. This strategy may prevent catastrophic postpartum haemorrhage requiring peripartum hysterectomy.
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ranking = 0.049916851787012
keywords = haemorrhage
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4/21. 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.
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ranking = 1
keywords = blood loss
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5/21. Percutaneous treatment of placenta percreta using coil embolization.

    PURPOSE: To report the use of embolotherapy to avoid hysterectomy in rare placenta percreta. CASE REPORT: A pregnant 34-year-old woman (gravida 3, para 2) was admitted with premature rupture of membranes and vaginal bleeding in the 32nd week. Prenatal B-mode and Doppler ultrasound revealed marked hypervascularity of the placenta with disruption of the uterine-bladder interface consistent with placenta percreta. Since the patient insisted on uterine preservation, uterus and placenta were left in situ after caesarean section, which was followed by coaxial microcoil embolization of 6 pelvic arteries and postoperative methotrexate administration. Three months later, the patient had severe bleeding from the retained placenta, possibly under the influence of anticoagulation administered for pulmonary embolism. Emergent hysterectomy was performed. CONCLUSIONS: Coil embolization may avoid immediate hysterectomy and reduce peri-delivery blood loss in placenta percreta. However, retained placenta poses a serious risk, even after months, and secondary hysterectomy should be performed as an elective procedure after embolization.
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ranking = 1
keywords = blood loss
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6/21. 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.
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ranking = 1
keywords = blood loss
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7/21. Postabortal haemorrhage and disseminated intravascular coagulation due to placenta accreta.

    We describe the case of a second trimester placenta accreta presenting as postabortal haemorrhage complicated by disseminated intravascular coagulation, requiring hysterectomy.
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ranking = 0.24958425893506
keywords = haemorrhage
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8/21. 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.
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ranking = 2
keywords = blood loss
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9/21. Term angular pregnancy with placenta accreta. A case report.

    A 27-year-old primigravida, with two prior adnexal operations, had retained placenta with postpartum haemorrhage following an uncomplicated vaginal delivery. Laparotomic removal revealed placental accretism. Pharmacological treatment (oxytocin and sulprostone) and right cornual resection failed to control profuse bleeding. In the end, subtotal hysterectomy was unavoidable.
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ranking = 0.049916851787012
keywords = haemorrhage
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10/21. Tourniquet technique prevents profuse blood loss in placenta accreta cesarean section.

    AIM: Profuse bleeding in placenta accreta is life-threatening even under well-prepared cesarean sections. methods: We used a tourniquet technique to temporally shut off blood flow through the uterine and ovarian vessels at the level of the uterine cervix. The tourniquet consisted of manual compression followed by a rubber tube. RESULTS: Total blood loss in cesarean section and hysterectomy in the two cases in which we applied this technique was significantly reduced compared with that in the two cases without it. CONCLUSION: This technique not only prevented massive bleeding from the accreted placentation, but also allowed physicians time to consider the necessity of subsequent hysterectomy.
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ranking = 5
keywords = blood loss
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