The management and outcomes of placenta accreta, increta, and percreta in the UK: a population‐based descriptive study
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Objective: To describe the management and outcomes of placenta accreta, increta, and percreta in the UK. Design: A population‐based descriptive study using the UK O bstetric S urveillance S ystem (UKOSS). Setting: All 221 UK hospitals with obstetrician‐led maternity units. Population: All women diagnosed with placenta accreta, increta, and percreta in the UK between May 2010 and April 2011. Methods: Prospective case identification through the monthly mailing of UKOSS. Main outcome measures: Median estimated blood loss, transfusion requirements. Results: A cohort of 134 women were identified with placenta accreta, increta, or percreta: 50% (66/133) were suspected to have this condition antenatally. In women with a final diagnosis of placenta increta or percreta, antenatal diagnosis was associated with reduced levels of haemorrhage (median estimated blood loss 2750 versus 6100 ml, P = 0.008) and a reduced need for blood transfusion (59 versus 94%, P = 0.014), possibly because antenatally diagnosed women were more likely to have preventative therapies for haemorrhage (74 versus 52%, P = 0.007), and were less likely to have an attempt made to remove their placenta (59 versus 93%, P < 0.001). Making no attempt to remove any of the placenta, in an attempt to conserve the uterus or prior to hysterectomy, was associated with reduced levels of haemorrhage (median estimated blood loss 1750 versus 3700 ml, P = 0.001) and a reduced need for blood transfusion (57 versus 86%, P < 0.001). Conclusions: Women with placenta accreta, increta, or percreta who have no attempt to remove any of their placenta, with the aim of conserving their uterus, or prior to hysterectomy, have reduced levels of haemorrhage and a reduced need for blood transfusion, supporting the recommendation of this practice.
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PAS becomes a clinical problem after birth, when the placenta does not physiologically detach from the uterus and the forcible removal of the placenta is followed by massive obstetric haemorrhage (MOH), leading to further morbidity and risk of maternal death.
“PAS becomes a clinical problem after birth, when the placenta does not physiologically detach from the uterus and the forcible removal of the placenta is followed by massive obstetric haemorrhage (MOH), leading to further morbidity and risk of maternal death.”
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Potential Serum Biomarkers in Prenatal Diagnosis of Placenta Accreta Spectrum
Zhang, T., & Wang, S. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.860186 · Cited by 31 · see citing works
Planned versus urgent deliveries in placenta previa: maternal, surgical and neonatal results
Durukan, H., Durukan, Ö. B., & Yazıcı, G. (2019) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-019-05349-9 · Cited by 30 · see citing works
Planned versus Unplanned Delivery for Placenta Accreta Spectrum
Bartal, M. F., Papanna, R. M., Zacharias, N., Soriano-Calderon, N., Limas, M., Blackwell, S. C., Chen, H.-Y., Chauhan, S. P., & Sibai, B. M. (2020) · American Journal of Perinatology · doi:10.1055/s-0040-1714676 · Cited by 32 · see citing works
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Outcomes of Subsequent Births After Placenta Accreta Spectrum
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Shorter the cervix, more difficult the placenta percreta operations
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Cost Savings of Red Cell Salvage During Cesarean Delivery
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Placenta accreta spectrum disorders - Peri-operative management: The role of the anaesthetist
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The recurrence risk of placenta accreta following uterine conserving management
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Pathologically Diagnosed Placenta Accreta and Hemorrhagic Morbidity in a Subsequent Pregnancy
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Patient selection for later delivery timing with suspected previa‐accreta
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Quality of life and sexual function after a pregnancy complicated by placenta accreta spectrum
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MRI of placenta percreta: differentiation from other entities of placental adhesive disorder
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Prospective First‐Trimester Ultrasound Imaging of Low Implantation and Placenta Accreta Spectrum
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Retracted“YouTube™ as a source of information on placenta accreta: A quality analysis”
Ruvolo, C. C., Califano, G., Tuccillo, A., Tolentino, S., Cancelliere, E., Bello, F. D., Celentano, G., Creta, M., Longo, N., Morra, S., et al. (2022) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2022.03.015 · Cited by 23 · see citing works
Placenta Accreta Spectrum (PAS) Disorder: Ultrasound versus Magnetic Resonance Imaging
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Gelany, S. E., Ibrahim, E. M., Mohammed, M., Abdelraheim, A. R., Khalifa, E. M., Abdelhakium, A. K., Yousef, A. M., Hassan, H., Goma, K., & Khairy, M. (2019) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-019-2244-4 · Cited by 21 · see citing works
Lipkind, H. S., Zuckerwise, L. C., Turner, E. B., Collins, J., Campbell, K. H., Reddy, U., Illuzzi, J. L., & Merriam, A. (2019) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.15818 · Cited by 21 · see citing works
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- Authors
- Fitzpatrick, K., Sellers, S., Spark, P., Kurinczuk, J., Brocklehurst, P., & Knight, M.
- Affiliations
- University of Oxford (GB)
- University Hospitals Bristol NHS Foundation Trust (GB)
- National Perinatal Epidemiology Unit University of Oxford Oxford UK
- University College London (GB)
- Corresponding author
- Fitzpatrick, KE
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2013-08-07
- Volume
- 121
- Issue
- 1
- Pages
- 62-71
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- PMC
- PMC3906842
- OpenAlex
- W2024611038
- Cited by
- 357
- References
- 16
- Citations by year
- 2026: 19 · 2025: 17 · 2024: 23 · 2023: 28 · 2022: 30 · 2021: 48 · 2020: 39 · 2019: 28 · 2018: 36 · 2017: 32 · 2016: 19 · 2015: 18 · 2014: 14 · 2013: 4
- FWCI
- 17.08
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by-nc)
- Funders
- National Institute for Health and Care Research (RP-PG-0608-10038)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Biochemistry › Blood transfusion and management
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Keywords
- placenta accreta, placenta increta, placenta percreta, prenatal diagnosis, uterine preservation, hysterectomy, obstetric hemorrhage, blood transfusion, estimated blood loss, placenta removal, UK Obstetric Surveillance System
- MeSH terms
- Blood Transfusion, Cesarean Section, Ergonovine, Female, United Kingdom, Postpartum Hemorrhage, Humans, Hysterectomy, Oxytocics, Oxytocin, Placenta Accreta, Pregnancy, Prospective Studies, Dinoprost, Cohort Studies, Misoprostol, Treatment Outcome, Uterine Artery Embolization
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