[Interest of modern imagery for conservative management of a placenta percreta]

Gynecol Obstet Fertil. 2007 Feb;35(2):142-8. doi: 10.1016/j.gyobfe.2006.12.009. Epub 2007 Jan 16.
[Article in French]

Abstract

The placenta percreta is a rare form of anomaly of placental insertion threatening the maternal and foetal lives. The incidence of abnormal placental adhesion is correlated to frequency of caesarean sections and advanced maternal age. Patients who are at high risk should be identified during pregnancy by ultrasound examination with Color Doppler looking for characteristic features. The practice of MRI in case of echographic suspicion may be useful, particularly in posterior placentas. A late diagnosis, in an emergency context, leads generally to hysterectomy and even to partial resection of neighbour organs. Thus, we report the case of a conservative management associating uterine embolisation following an elective caesarean delivery at 36 weeks gestation. In postpartum, the placental involution was followed clinically and by imagery. In our case, a total abdominal hysterectomy was performed on the fifth postoperative week because of a severe antibiotics resistant infection. No blood transfusion was required and the postoperative period was uneventful. This clinical case aims to show, through an analysis of the recent data of the literature, the interest of modern imagery to select patients with suspected placenta percreta that would be suitable candidates for conservative management.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adult
  • Cesarean Section
  • Embolization, Therapeutic*
  • Female
  • Humans
  • Hysterectomy
  • Magnetic Resonance Imaging / methods*
  • Placenta Accreta / diagnosis
  • Placenta Accreta / surgery*
  • Placenta Accreta / therapy*
  • Postpartum Period
  • Pregnancy
  • Pregnancy Complications
  • Pregnancy Outcome
  • Risk Factors
  • Streptococcal Infections / drug therapy
  • Streptococcal Infections / surgery
  • Ultrasonography, Doppler
  • Ultrasonography, Prenatal / methods*