The Triple-P procedure as a conservative surgical alternative to peripartum hysterectomy for placenta percreta
Abstract
The reported maternal mortality for morbidly adherent placenta ranges from 7% to 10% worldwide. Current treatment modalities for this potentially life-threatening condition include radical approaches such as elective peripartum hysterectomy with or without bowel/bladder resection or ureteric re-implantation (for placenta percreta infiltrating these organs), and conservative measures such as compression sutures with balloon tamponade and the placenta remaining in situ. However, both conservative and radical measures are associated with significant maternal morbidity and mortality. The present article describes the Triple-P procedure-which involves perioperative placental localization and delivery of the fetus via transverse uterine incision above the upper border of the placenta; pelvic devascularization; and placental non-separation with myometrial excision and reconstruction of the uterine wall-as a safe and effective alternative to conservative management or peripartum hysterectomy.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Although the UK and French studies were conducted during a comparable time period, the evolution of knowledge, awareness and management of PAS across this time period may be a partial explanation for the differences in outcomes between the countries.
“Although the UK and French studies were conducted during a comparable time period, allowing appropriate comparison, the evolution of knowledge, awareness and management of PAS across this time period may be a partial explanation for the differences in outcomes between the countries.”
Cites
Abnormal placentation: Twenty-year analysis
Wu, S., Kocherginsky, M., & Hibbard, J. U. (2005) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2004.12.074 · Cited by 1,331 · see citing works
Maternal Outcome After Conservative Treatment of Placenta Accreta
Sentilhes, L., Ambroselli, C., Kayem, G., Provansal, M., Fernandez, H., Perrotin, F., Winer, N., Pierre, F., Benachi, A., Dreyfus, M., et al. (2010) · Obstetrics & Gynecology · doi:10.1097/aog.0b013e3181d066d4 · Cited by 515 · see citing works
Anterior placenta percreta: surgical approach, hemostasis and uterine repair
Palacios-Jaraquemada, J. M., Pesaresi, M., Nassif, J. C., & Hermosid, S. (2004) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/j.0001-6349.2004.00517.x · Cited by 229 · see citing works
Placenta creta and placenta praevia creta
Khong, T. Y., & Robertson, W. B. (1987) · Placenta · doi:10.1016/0143-4004(87)90067-1 · Cited by 193 · see citing works
Morbidity and Mortality of Peripartum Hysterectomy
Wright, J. D., Devine, P., Shah, M. M., Gaddipati, S., Lewin, S. N., Simpson, L. L., Bonanno, C., Sun, X., D’Alton, M. E., & Herzog, T. J. (2010) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e3181df94fb · Cited by 160 · see citing works
Diagnosis and management of placenta accreta
Palacios-Jaraquemada, J. M. (2008) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2008.08.003 · Cited by 123 · see citing works
Surgical aspects of postpartum haemorrhage
Chandraharan, E., & Arulkumaran, S. (2008) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2008.08.001 · Cited by 64 · see citing works
Self-citationObstetric hysterectomy: fifteen years' experience in a Nigerian tertiary centre
Okogbenin, S., Gharoro, E., Otoide, V. O., & Okonta, P. I. (2003) · Journal of Obstetrics and Gynaecology · doi:10.1080/0144361031000119475 · Cited by 54 · see citing works
The use of the ‘tamponade test’ to stop massive obstetric haemorrhage in placenta accreta
Frenzel, D., Condous, G. S., Papageorghiou, A. T., & McWhinney, N. (2005) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2005.00491.x · Cited by 42 · see citing works
Uterus‐conserving surgery: tactics to avoid bleeding in placenta percreta
Palacios-Jaraquemada, J. M. (2008) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2008.01914.x · Cited by 7 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Abnormal Placentation: Placenta Previa, Vasa Previa, and Placenta Accreta
Silver, R. M. (2015) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000001005 · Cited by 519 · see citing works
D'Antonio, F., Iacovella, C., & Bhide, A. (2013) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.13194 · Cited by 398 · see citing works
Collins, S. L., Alemdar, B., van Beekhuizen, H. J., Bertholdt, C., Braun, T., Calda, P., Delorme, P., Duvekot, J. J., Gronbeck, L., Kayem, G., et al. (2019) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2019.02.054 · Cited by 350 · see citing works
Sentilhes, L., Kayem, G., Chandraharan, E., Palacios‐Jaraquemada, J., Jauniaux, E., & Panel, F. T. F. P. A. D. A. M. E. C. (2018) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.12410 · Cited by 322 · see citing works
Self-citationCesarean scar pregnancy is a precursor of morbidly adherent placenta
Timor‐Tritsch, I. E., Monteagudo, A., Calì, G., Vintzileos, A. M., Viscarello, R. R., Al‐Khan, A., Zamudio, S., Mayberry, P., Cordoba, M. I., & Dar, P. (2014) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.13426 · Cited by 253 · see citing works
“Chanddraharan et al.21 have also described their uterus-sparing ‘Triple P procedure’.”
MethodConservative management of morbidly adherent placenta: expert review
Fox, K. A., Shamshirsaz, A. A., Carusi, D., Secord, A. A., Lee, P., Turan, O. M., Huls, C., Abuhamad, A., Simhan, H., Barton, J., et al. (2015) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2015.04.034 · Cited by 210 · see citing works
“patients with central, anterior placenta percreta.(19) This procedure involves 3 steps: 1) 195 preoperative placental localization using transabdominal ultrasound to identify the 196 superior border of the placenta, with transverse hysterotomy planned 2-fingerbreadths 197 above the uppermost placental edge; 2) preoper…”
BackgroundMethodPalacios-Jaraquemada, J. M., Fiorillo, A., Hamer, J., Martínez, M., & Bruno, C. (2022) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2020.1716715 · Cited by 155 · see citing works
“reduce the frequency of morbidity [6] and to preserve the uterus for a subsequent pregnancy [7].”
BackgroundKingdom, J. C., Hobson, S. R., Murji, A., Allen, L. M., Windrim, R. C., Lockhart, E. L., Collins, S., majd, H. S., Alazzam, M., Naaisa, F., et al. (2020) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2020.01.044 · Cited by 133 · see citing works
Risk factors for abnormally invasive placenta: a systematic review and meta-analysis
Iacovelli, A., Liberati, M., Khalil, A. A., Timor‐Trisch, I., Leombroni, M., Buca, D. I. P., Milani, M., Flacco, M. E., Manzoli, L., Fanfani, F., et al. (2018) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2018.1493453 · Cited by 111 · see citing works
“Women affected by AIP require a tailored surgical management which is commonly accomplished by fundal hysterotomy, followed by delivery of the fetus and subsequent elective hysterectomy, although recent evidences suggest that an appropriate hemostatic control can be achieved by conservative techniques aiming at preser…”
BackgroundNo. 383-Screening, Diagnosis, and Management of Placenta Accreta Spectrum Disorders
Hobson, S. R., Kingdom, J. C., Murji, A., Windrim, R. C., Carvalho, J. C. A., Singh, S. S., Ziegler, C., Birch, C., Frecker, E., Lim, K. I., et al. (2019) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/j.jogc.2018.12.004 · Cited by 112 · see citing works
“PAS: placenta accreta spectrum. delivery of the placenta or successful wedge resection (triple-P procedure 45 ) of focally invasive PAS disorders, postoperative recovery including extended use of an epidural infusion for 24 hours.”
Maternal morbidity and mortality due to placenta accreta spectrum disorders
Fonseca, A., & Ayres de Campos, D. (2021) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2020.07.011 · Cited by 102 · see citing works
An update on the risk factors for and management of obstetric haemorrhage
Sebghati, M., & Chandraharan, E. (2017) · Women s Health · doi:10.1177/1745505717716860 · Cited by 102 · see citing works
Self-citationEinerson, B. D., Gilner, J. B., & Zuckerwise, L. C. (2023) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000005229 · Cited by 100 · see citing works
Carrillo, A. P., & Chandraharan, E. (2019) · Women s Health · doi:10.1177/1745506519878081 · Cited by 103 · see citing works
Self-citationTeixidor Viñas, M., Belli, A. M., Arulkumaran, S., & Chandraharan, E. (2015) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.14728 · Cited by 96 · see citing works
Self-citationGelany, S. E., Mosbeh, M., Ibrahim, E. M., Mohammed, M., Khalifa, E. M., Abdelhakium, A. K., Yousef, A. M., Hassan, H., Goma, K., Alghany, A. A., et al. (2019) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-019-2466-5 · Cited by 104 · see citing works
Sentilhes, L., Seco, A., Azria, É., Beucher, G., Bonnet, M., Branger, B., Carbillon, L., Chiesa-Dubruille, C., Crenn‐Hébert, C., Dreyfus, M., et al. (2021) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2021.12.013 · Cited by 97 · see citing works
What we know about placenta accreta spectrum (PAS)
Liu, X., Yu, W., Wu, Y., Zeng, J., Yuan, X., Tong, C., & Qi, H. (2021) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2021.02.001 · Cited by 101 · see citing works
Caesarean section in cases of placenta praevia and accreta
Palacios-Jaraquemada, J. M. (2012) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2012.10.003 · Cited by 81 · see citing works
Teixidor Viñas, M., Chandraharan, E., Moneta, M. V., & Belli, A. M. (2014) · Clinical Radiology · doi:10.1016/j.crad.2014.04.005 · Cited by 76 · see citing works
Self-citationConservative management of placenta percreta
Matsuzaki, S., Yoshino, K., Endo, M., Kakigano, A., Takiuchi, T., & Kimura, T. (2017) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.12411 · Cited by 76 · see citing works
“Therapeutic UAE with subsequent manual placenta removal 1/72 (1)”
BackgroundInfluentialSurgical management of placenta accreta: to leave or remove the placenta?
Perez‐Delboy, A., & Wright, J. (2013) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.12524 · Cited by 69 · see citing works
Kütük, M. S., Ak, M., & Özgün, M. T. (2017) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.12308 · Cited by 62 · see citing works
Placenta accreta spectrum-a catastrophic situation in obstetrics
Pegu, B., Chitra, T., Nayak, D., & Subbaiah, M. (2021) · Obstetrics & Gynecology Science · doi:10.5468/ogs.20345 · Cited by 59 · see citing works
“This procedure reduces not only the operative time but also the need for ICU admission and overall hospital stay [46,47].”
BackgroundAryananda, R. A., ADITIAWARMAN, A., Gumilar, K. E., Wardhana, M. P., Akbar, M. I. A., Cininta, N. I., Ernawati, E., Wicaksono, B., Joewono, H. T., Dachlan, E. G., et al. (2022) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.14348 · Cited by 49 · see citing works
Morel, O., Collins, S., Uzan-Augui, J., Masselli, G., Duan, J., Chabot-Lecoanet, A.-C., Braun, T., Langhoff‐Roos, J., Soyer, P. A., & Chantraine, F. (2019) · Diagnostic and Interventional Imaging · doi:10.1016/j.diii.2019.02.004 · Cited by 47 · see citing works
Updates on the management of placenta accreta spectrum
Mascio, D. D., Calì, G., & D’Antonio, F. (2019) · Minerva Obstetrics and Gynecology · doi:10.23736/s0026-4784.18.04333-2 · Cited by 45 · see citing works
The diagnosis and management of morbidly adherent placenta
Belfort, M. A., Shamshirsaz, A. A., & Fox, K. A. (2017) · Seminars in Perinatology · doi:10.1053/j.semperi.2017.11.009 · Cited by 43 · see citing works
Morbidly Adherent Placenta: Its Management and Maternal and Perinatal Outcome
Chaudhari, H. K., Shah, P. K., & D'Souza, N. (2016) · The Journal of Obstetrics and Gynecology of India · doi:10.1007/s13224-016-0923-x · Cited by 40 · see citing works
“The reported maternal mortality for morbidly adherent placenta ranges from 7 to 10 % worldwide [21].”
Backgrounddi Pasquo, E., Ghi, T., Calì, G., D'Antonio, F., Fratelli, N., Forlani, F., Prefumo, F., Kaihura, C. T., Volpe, N., Dall’Asta, A., et al. (2019) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.21866 · Cited by 40 · see citing works
Etiopathogenesis and risk factors for placental accreta spectrum disorders
Ali, H., & Chandraharan, E. (2020) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2020.07.006 · Cited by 40 · see citing works
Self-citationCoutinho, C. M., Giorgione, V., Noël, L., Liu, B., Chandraharan, E., Pryce, J. W., Frick, A., Thilaganathan, B., & Bhide, A. (2020) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.23100 · Cited by 39 · see citing works
Self-citationMcCall, S. J., Deneux‐Tharaux, C., Sentilhes, L., Ramakrishnan, R., Collins, S. L., Seco, A., Kurinczuk, J. J., Knight, M., & Kayem, G. (2022) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.17169 · Cited by 38 · see citing works
Carrillo, A. P., Bhide, A., Moore, J., Hartopp, R., Belli, A., Arulkumaran, S., Thilaganathan, B., & Chandraharan, E. (2019) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.12990 · Cited by 38 · see citing works
Self-citationPerioperative management of undiagnosed placenta percreta: case report and management strategies
Sivasankar, C. (2012) · International Journal of Women s Health · doi:10.2147/ijwh.s35104 · Cited by 36 · see citing works
“Introduction Adherent placenta accounts for 7%–10% of maternal mortality cases worldwide.(1) Placenta percreta is a rare type of adherent placenta that, when not diagnosed early, can lead to severe maternal morbidity.”
Gelany, S. E., Abdelraheim, A. R., Mohammed, M., El-Rab, M. T. G., Yousef, A. M., Ibrahim, E. M., & Khalifa, E. M. (2015) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-015-0731-9 · Cited by 34 · see citing works
“The maternal mortality in women with PA may reach as high as 7–10 % [3, 6–8].”
BackgroundTeare, J., Evans, E., Belli, A., & Wendler, R. (2014) · International Journal of Obstetric Anesthesia · doi:10.1016/j.ijoa.2013.11.002 · Cited by 33 · see citing works
Self-citationKaraman, E., Kolusarı, A., Çetin, O., Çim, N., Alkış, İ., Yıldızhan, R., Şahin, H. G., & Gül, A. (2016) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2016.1192119 · Cited by 33 · see citing works
“However, the term accreta is frequently preferred and used for the three types [3].”
BackgroundMethodInfluentialPlacenta accreta spectrum disorders clinical practice guidelines: A systematic review
Capannolo, G., D’Amico, A., Alameddine, S., Girolamo, R. D., Khalil, A. A., Calì, G., Trish, I. T., Coutinho, C. M., Herrera, M., Liberati, M., et al. (2023) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.15544 · Cited by 33 · see citing works
Schwickert, A., Chantraine, F., Ehrlich, L., Henrich, W., Muallem, M. Z., Nonnenmacher, A., Petit, P., Weizsäcker, K., & Braun, T. (2020) · Reproductive Sciences · doi:10.1007/s43032-020-00319-y · Cited by 30 · see citing works
Nieto‐Calvache, A. J., Zambrano, M., Herrera, N. A., Usma, A., Bryon, A. M., Calvache, J. P. B., López, L., Mejía, M., & Palacios-Jaraquemada, J. M. (2019) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2019.1615877 · Cited by 30 · see citing works
Wei, Y., Cao, Y., Yu, Y., & Wang, Z. (2017) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-017-4447-0 · Cited by 28 · see citing works
Effectiveness of segmental resection technique in the treatment of placenta accreta spectrum
Çırpan, T., Akdemir, A., Ökmen, F., Hortu, İ., Ekici, H., & İmamoğlu, M. (2019) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2019.1702019 · Cited by 26 · see citing works
“defined the “Triple P” technique in four cases with anterior placenta percreta [14].”
MethodPaping, A., Bluth, A., Naimi, A. A., Gzirí, M. M., Kolak, M. L., Jaworowski, A. P., Huras, H. K., Morlando, M., Daskalakis, G., Pinto, P. V., et al. (2024) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.14855 · Cited by 25 · see citing works
Angileri, S. A., Mailli, L., Raspanti, C., Ierardi, A. M., Carrafiello, G., & Belli, A. (2017) · La radiologia medica · doi:10.1007/s11547-017-0777-z · Cited by 27 · see citing works
Self-citationConservative surgical approach: The Triple P procedure
Carrillo, A. P., & Chandraharan, E. (2020) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2020.07.009 · Cited by 25 · see citing works
Self-citationZhao, X., Tao, Y., Du, Y., Zhao, L., Liu, C., Zhou, Y., & Peng, W. (2018) · Taiwanese Journal of Obstetrics and Gynecology · doi:10.1016/j.tjog.2018.02.017 · Cited by 25 · see citing works
Miyakoshi, K., Otani, T., Kondoh, E., Makino, S., Tanaka, M., & Takeda, S. (2017) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.12397 · Cited by 24 · see citing works
How to set up a regional specialist referral service for Placenta Accreta Spectrum (PAS) disorders?
Chandraharan, E., Hartopp, R., Thilaganathan, B., & Coutinho, C. M. (2020) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2020.07.007 · Cited by 23 · see citing works
Self-citationRole of interventional radiology in placenta accreta spectrum (PAS) disorders
Hawthorn, B. R., & Ratnam, L. (2021) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2021.01.007 · Cited by 23 · see citing works
Melekoğlu, R., Çelik, E., Eraslan, S., & Büyükkurt, S. (2016) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.13215 · Cited by 22 · see citing works
“described their procedure as triple P in 2006, and they reported remarkably low blood loss, ranging from 800 to 1500mLper patient.(13) A follow-up cohort study by the same group showed a reduction in estimated blood loss, need for delayed hysterectomy, and length of inpatient stay compared with leaving the placenta in…”
MethodMatsuzaki, S., Yoshino, K., Kumasawa, K., Satou, N., Mimura, K., Kanagawa, T., Ueda, Y., & Kimura, T. (2014) · Clinical Case Reports · doi:10.1002/ccr3.108 · Cited by 21 · see citing works
Uterine conservation in placenta accrete spectrum (PAS) disorders: A retrospective case series
Lional, K. M., Tagore, S., & Wright, A. M. (2020) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2020.09.029 · Cited by 20 · see citing works
Conservative management versus cesarean hysterectomy in patients with placenta increta or percreta
Wang, Q., Ma, J., Zhang, H., Dou, R., Huang, B., Wang, X., Zhao, X., Chen, D., Ding, Y., Ding, H., et al. (2020) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2020.1774871 · Cited by 18 · see citing works
Durukan, H., Durukan, Ö. B., & Yazıcı, G. (2020) · Journal of Obstetrics and Gynaecology · doi:10.1080/01443615.2020.1755629 · Cited by 18 · see citing works
“As demand for uterus-sparing surgery has increased, a number of conservative management options have been introduced (Allahdin et al. 2011; Chandraharan et al. 2012; Karaman et al. 2017; Pala et al. 2018).”
BackgroundPlacenta Accreta Spectrum: Conservative Management and Its Impact on Future Fertility
Abbas, R. A., & Nassar, A. H. (2020) · Maternal-Fetal Medicine · doi:10.1097/fm9.0000000000000077 · Cited by 20 · see citing works
“28,29 It consists of perioperative location of the upper border of the placenta pelvic devascularization by a pre-placed pelvic arterial balloon catheter in the anterior division of the internal iliac artery after delivery of the fetus in attempt to reduce the blood supply to the placenta, and in…”
BackgroundInfluentialPlacenta Accreta Spectrum: A Comprehensive Review of Guidelines
Giouleka, S., Tsakiridis, I. G., Chanioti, E.-R., Ladas, K., Liberis, A., Mamopoulos, A. M., Kalogiannidis, I. A., Athanasiadis, A. P., & Dagklis, T. (2024) · Obstetrical & Gynecological Survey · doi:10.1097/ogx.0000000000001274 · Cited by 20 · see citing works
Management of morbidly adherent placenta
Narang, L., & Chandraharan, E. (2013) · Obstetrics Gynaecology & Reproductive Medicine · doi:10.1016/j.ogrm.2013.06.002 · Cited by 18 · see citing works
Self-citationConservative management of placental invasion anomalies with an intracavitary suture technique
Acar, A., Ercan, F., Pekin, A. T., Atılgan, A. E., Sayal, H. B., Balcı, O., & Görkemli, H. (2018) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.12593 · Cited by 18 · see citing works
Dall’Asta, A., Calì, G., Forlani, F., Paramasivam, G., Girardelli, S., Yazbek, J., D’Antonio, F., Bhide, A., & Lees, C. C. (2020) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2020.04.038 · Cited by 17 · see citing works
Management of abnormal invasive placenta in a low- and medium-resource setting
Escobar, M. F., Gallego, J. C., Nasner, D., & Gunawardana, K. (2020) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2020.08.004 · Cited by 17 · see citing works
Recognition and Management of Postpartum Hemorrhage
Mohamed, T. A. E. H., & Chandraharan, E. (2024) · Maternal-Fetal Medicine · doi:10.1097/fm9.0000000000000256 · Cited by 16 · see citing works
Self-citationSuccessful pregnancy outcome in woman with history of Triple‐P procedure for placenta percreta
Cauldwell, M., Chandraharan, E., Carrillo, A. P., & Pereira, S. (2017) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.17566 · Cited by 16 · see citing works
Self-citationYang, C.-C., Chou, Y.-C., Kuo, T., Liou, J., Cheng, H.-M., & Kuo, Y. (2021) · CardioVascular and Interventional Radiology · doi:10.1007/s00270-021-02921-2 · Cited by 15 · see citing works
Varlas, V. N., Roxana Georgiana, B. O. R. S., Birsanu, S., Maxim, B., Cloțea, E., & Mihailov, M. (2021) · Journal of Medicine and Life · doi:10.25122/jml-2021-0134 · Cited by 14 · see citing works
““The triple P procedure” includes the following steps: preoperative placental topography to identify the upper edge of the placenta; use of occlusal balloons in the iliac arteries to reduce blood flow to the placental bed and resection of the placenta with the underlying adherent myometrium without separation, followe…”
BackgroundManagement of morbidly adherent placenta
Carrillo, A. P., & Chandraharan, E. (2016) · Obstetrics Gynaecology & Reproductive Medicine · doi:10.1016/j.ogrm.2016.07.006 · Cited by 14 · see citing works
Self-citationThe Use of Modified Triple-P Method with Adherent Placenta Long - Term Results
Цхай, В. Ф. (2017) · MOJ Women s Health · doi:10.15406/mojwh.2017.04.00079 · Cited by 14 · see citing works
Risk of hemorrhage in abnormally invasive placenta according to its management
Pinto, P. V., Machado, A. P., & Montenegro, N. A. M. D. M. (2016) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2016.1240163 · Cited by 14 · see citing works
Maireche, A. (2018) · Open Access Journal of Mathematical and Theoretical Physics · doi:10.15406/oajmtp.2018.01.00040 · Cited by 13 · see citing works
Aboelroose, A. A., Ahmed, M. R., Shaaban, M. M., Ghoneim, H. M., & Mohamed, T. Y. (2019) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2019.1678145 · Cited by 13 · see citing works
“Their technique involved accurate placental localization, supra placental incision for delivery of the fetus and devascularization followed by lower segment resection [17].”
BackgroundMethodInfluentialPlacenta percreta in primigravida, an unsuspected situation
Rajkumar, B., Kumar, N. S., & Srinivasan, S. (2014) · International Journal of Reproduction Contraception Obstetrics and Gynecology · doi:10.5455/2320-1770.ijrcog20140349 · Cited by 13 · see citing works
Welz, J., Keyver-Paik, M.-D., Gembruch, U., & Merz, W. M. (2019) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-019-05175-z · Cited by 13 · see citing works
Peng, X., Chen, D., Xu, J., Liu, X., You, Y., & Peng, B. (2019) · Medicine · doi:10.1097/md.0000000000017742 · Cited by 13 · see citing works
“As for surgical technique, it primarily includes 1-step conservative surgery([19]) and the triple-P procedure,([18]) variations such as transverse uterine fundal incision([7]) and the stepwise approach.”
MethodTrends, characteristics, and outcomes of conservative management for placenta percreta
Youssefzadeh, A. C., Matsuzaki, S., Mandelbaum, R. S., Sangara, R. N., Bainvoll, L., Matsushima, K., Ouzounian, J. G., & Matsuo, K. (2022) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-021-06384-1 · Cited by 13 · see citing works
“A variety of strategies for local resection [11, 12, 17, 26, 35] and adjunctive procedures such as pelvic vasculature arterial balloon occlusion, uterine artery embolization, and use of adjuvant chemotherapeutic agents have been described [14, 36].”
BackgroundChandraharan, E. (2012) · Women s Health · doi:10.2217/whe.12.24 · Cited by 13 · see citing works
“The ‘Triple-P procedure’ for percreta has been developed as a conservative surgical alternative to peripartum hysterectomy [7].”
BackgroundSelf-citationEl Tahan, M., Carrillo, A. P., Moore, J., & Chandraharan, E. (2018) · Journal of Obstetrics and Gynaecology · doi:10.1080/01443615.2017.1334141 · Cited by 12 · see citing works
“The Triple-P Procedure is a new three-step conservative surgery for abnormal invasion of the placenta (Chandraharan et al. 2012).”
BackgroundSelf-citationHigh‐intensity focused ultrasound in management of placenta accreta spectrum: A systematic review
Elazeem, H. A. S. A., Saad, M. M., Ahmed, I., Sayed, E. G., AlMahdy, A. M., Atef, F., Elassall, G. M., Salah, M. A., Ali, A. K., Ragab, E. Y., et al. (2020) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.13391 · Cited by 12 · see citing works
Bertucci, E., Sileo, F. G., Grandi, G., Fenu, V., Cani, C., Mancini, L., Mataca, E., & Facchinetti, F. (2017) · Ultraschall in der Medizin - European Journal of Ultrasound · doi:10.1055/s-0043-119872 · Cited by 11 · see citing works
Patabendige, M., Sanjeewa, J. M. P., Amarasekara, A. M. A. K. G., & Herath, R. P. (2020) · Case Reports in Obstetrics and Gynecology · doi:10.1155/2020/9065342 · Cited by 10 · see citing works
“Other than expectant management with a placenta in situ approach, three further conservative approaches have been described in the literature, namely, extirpative technique (manual removal of the placenta), one-step conservative surgery (removal of the accreta area), and the Triple-P procedure (suturing around the acc…”
Uterine Sparing Techniques in Placenta Accreta
Shehata (2016) · Obstetrics & Gynecology International Journal · doi:10.15406/ogij.2016.05.00143 · Cited by 9 · see citing works
“It is considered a safe and effective alternative to conservative management or peripartum hysterectomy [38].”
BackgroundWildschut, H. I. J., Duvekot, J. J., Cook, J. R., Bacchus, L. J., Bewley, S., Creighton, S. M., Dear, J., Williams, D., Kilby, M. D., Crouch, N. S., et al. (2017) · Cambridge University Press eBooks · doi:10.1017/9781108349185 · Cited by 10 · see citing works
Postpartum haemorrhage and haematological management
Carrillo, A. P., & Chandraharan, E. (2014) · Obstetrics Gynaecology & Reproductive Medicine · doi:10.1016/j.ogrm.2014.07.004 · Cited by 9 · see citing works
Self-citationMousa, A., Elkhateb, I. T., Gaafar, H. M., Elsherbini, M. M., Mousa, H., Abdalla, M., Abdelbar, A., Shibli, D., majd, H. S., & Collins, S. (2023) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2023.03.026 · Cited by 8 · see citing works
Dawood, A. S., Elgergawy, A. E.-S., & Elhalwagy, A. (2018) · Journal of Gynecology Obstetrics and Human Reproduction · doi:10.1016/j.jogoh.2018.10.007 · Cited by 8 · see citing works
RetractedMazzon, I., Favilli, A., Grasso, M., Horvath, S., & Gerli, S. (2015) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.3109/14767058.2015.1056147 · Cited by 8 · see citing works
“In some cases, a multiple approach was described [5].”
Undiagnosed placenta praevia percreta: A rare case report and review of management
Okunowo, A., Ohazurike, E. O., & Habeebu-Adeyemi, F. (2019) · Nigerian Postgraduate Medical Journal · doi:10.4103/npmj.npmj_191_18 · Cited by 10 · see citing works
Drăguşin, R. C., Șorop-Florea, M., Pătru, C. L., Zorilă, G. L., Marinas, C., Sorop, B., Căpitănescu, R., & Iliescu, D. G. (2018) · InTech eBooks · doi:10.5772/intechopen.75985 · Cited by 7 · see citing works
General Management Considerations for Placenta Accreta Spectrum
Einerson, B. D., Sandlin, A. T., Afshar, Y., Sharawi, N., Fox, K. A., Newton, J. M., Shainker, S. A., Pezeshkmehr, A. H., Carusi, D. A., & Moroz, L. A. (2023) · American Journal of Perinatology · doi:10.1055/s-0043-1761915 · Cited by 6 · see citing works
Zhao, H., Zhao, X., Chen, C., Tao, Y., & Guo, R. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.839716 · Cited by 6 · see citing works
Abouda, H. S., Aloui, H., Azouz, E., Marzouk, S. B., Frikha, H., Hammami, R., Minjli, S., Hentati, R., Khila, M., Chanoufi, B., et al. (2024) · AJOG Global Reports · doi:10.1016/j.xagr.2024.100430 · Cited by 6 · see citing works
Docheva, N., Slutsky, E. D., Borella, N., Mason, R., Hook, J. W. V., & Seo-Patel, S. (2018) · Case Reports in Obstetrics and Gynecology · doi:10.1155/2018/8797643 · Cited by 6 · see citing works
“Chandraharan describes the surgery as follows: perioperative placental localization and delivery of the fetus via transverse uterine incision above the upper border of the placenta, pelvic devascularization, and placental nonseparation with myometrial excision and reconstruction of the uterine wall [34].”
Conservative Surgical Treatment of a Case of Placenta Accreta
Bıyık, İ., Keskin, F., & Keskin, E. U. (2018) · Revista Brasileira Ginecologia e Obstetrícia · doi:10.1055/s-0038-1668528 · Cited by 6 · see citing works
Maternal outcomes after different surgical techniques in placenta accreta: a prospective study
Kansouh, A., & Eldin, E. S. (2018) · Journal of Medicine in Scientific Research · doi:10.4103/jmisr.jmisr_77_18 · Cited by 6 · see citing works
Placenta Accreta Spectrum 2021: Roundtable Discussion
Fox, K. A., Cassady, C. I., Collins, S., Einerson, B. D., Hobson, S. R., Palacios-Jaraquemada, J. M., Shrivastava, V. K., & Lee, W. (2021) · Journal of Ultrasound in Medicine · doi:10.1002/jum.15685 · Cited by 6 · see citing works
Orsi, M., Ossola, M. W., Iurlaro, E., Perugino, G., Somigliana, E., & Ferrazzi, E. M. (2022) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2022.02.017 · Cited by 6 · see citing works
Bourrellier, L., Bensalem, R., Bersot, Y., Bertrand, A., Duminil, L., Malinovsky, J., Bonneau, S., Graesslin, O., & Raimond, É. (2017) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2017.06.031 · Cited by 6 · see citing works
“To avoid these complications some teams proposed the triple-P procedure ("perioperative placental placement, pelvic devascularization and non-placental separation and myometrial excision") to avoid haemostatic hysterectomy and long latency before placental regression (5).”
MethodPanaitescu, A. M., Peltecu, G. C., Botezatu, R., Iancu, G., & Gică, N. (2022) · Medicina · doi:10.3390/medicina58050678 · Cited by 5 · see citing works
Yalınkaya, A., & Oğlak, S. C. (2024) · Journal of Pregnancy · doi:10.1155/2024/9910316 · Cited by 5 · see citing works
“Also, some other studies employed transverse skin incision and after that a transverse uterine incision in cases with PAS [34, 35].”
ResultNo 383 – Dépistage, diagnostic et prise en charge des troubles du spectre du placenta accreta
Hobson, S. R., Kingdom, J. C., Murji, A., Windrim, R. C., Carvalho, J. C. A., Singh, S. S., Ziegler, C., Birch, C., Frecker, E., Lim, K. I., et al. (2019) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/j.jogc.2019.04.002 · Cited by 5 · see citing works
Gan, Y., Chen, Z., & Shi, Q. (2020) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-020-05625-z · Cited by 5 · see citing works
- Authors
- Chandraharan, E., Rao, S., Belli, A.-M., & Arulkumaran, S.
- Affiliations
- St George’s University Hospitals NHS Foundation Trust (GB)
- Corresponding author
- Chandraharan, Edwin
- Venue
- International Journal of Gynecology & Obstetrics
- Publisher
- Wiley
- Published
- 2012-02-11
- Volume
- 117
- Issue
- 2
- Pages
- 191-194
- ISSN
- 0020-6695 (ISSN-L)
- 0020-7292
- OpenAlex
- W2006699354
- Cited by
- 221
- References
- 10
- Citations by year
- 2026: 13 · 2025: 11 · 2024: 15 · 2023: 17 · 2022: 16 · 2021: 18 · 2020: 25 · 2019: 24 · 2018: 17 · 2017: 23 · 2016: 15 · 2015: 6 · 2014: 10 · 2013: 6 · 2012: 5
- FWCI
- 7.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Gynecology & Obstetrics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Biochemistry › Blood transfusion and management
- Keywords
- placenta percreta, placenta accreta spectrum, peripartum hysterectomy, conservative treatment, uterine reconstruction, maternal mortality, maternal morbidity
- MeSH terms
- Female, Postpartum Hemorrhage, Humans, Hysterectomy, Maternal Mortality, Myometrium, Placenta Accreta, Pregnancy, Uterus, Plastic Surgery Procedures, Delivery, Obstetric, Peripartum Period
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
