Management of placenta accreta
Open accessAbstract
Cesarean hysterectomy is considered the reference standard treatment for placenta accreta. In young women who want the option of future pregnancy and agree to close follow‐up monitoring, conservative treatment is a valid option. Several key points of both cesarean hysterectomy and conservative treatment remain debatable, such as timing of delivery, attempted removal of the placenta, use of temporal internal iliac occlusion balloon catheters, ureteral stents, prophylactic embolization, and methotrexate. In cases of placenta percreta with bladder involvement, conservative treatment may be the optimal management. Regardless of the chosen option, the woman and her partner should be warned of the high risk of maternal complications related to an abnormally invasive placenta.
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These findings suggest that clinicians in the UK and France did not adhere to clinical guidelines of not attempting manual removal of the placenta and leaving the placenta undisturbed when PAS is suspected.
“These findings suggest that clinicians in the UK and France did not adhere to the clinical guidelines of not attempting a manual removal of the placenta and leaving the placenta undisturbed when PAS is suspected.”
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- Authors
- Sentilhes, L., Goffinet, F., & Kayem, G.
- Affiliations
- Department of Obstetrics and Gynecology Angers University Hospital Angers France
- Hôpital Cochin (FR)
- Hôpital Louis-Mourier (FR)
- Venue
- Acta Obstetricia et Gynecologica Scandinavica
- Publisher
- Wiley
- Published
- 2013-09-16
- Volume
- 92
- Issue
- 10
- Pages
- 1125-1134
- ISSN
- 0001-6349 (ISSN-L)
- 1600-0412
- OpenAlex
- W2064366445
- Cited by
- 140
- References
- 40
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 14 · 2023: 8 · 2022: 13 · 2021: 9 · 2020: 10 · 2019: 12 · 2018: 14 · 2017: 21 · 2016: 9 · 2015: 6 · 2014: 7 · 2013: 1
- FWCI
- 1.09
- Type
- journal article
- Language
- en
- Open access
- green
- inserm.hal.science
- Licence
- Locations
- Acta Obstetricia Et Gynecologica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- 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 accreta, placenta percreta, cesarean hysterectomy, conservative treatment, timing of delivery, placental removal, ureteral stent, prophylactic embolization, methotrexate, maternal complications
- MeSH terms
- Abortifacient Agents, Nonsteroidal, Cesarean Section, Combined Modality Therapy, Female, Hemostatic Techniques, Humans, Hysterectomy, Methotrexate, Placenta Accreta, Pregnancy, Prenatal Diagnosis, Fertility Preservation
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