Conservative Management of Placenta Percreta: Three Cases and a Review of the Literature regarding Conservative Management of Placenta Accreta Spectrum (PAS) Disorders.

Background. The incidence of placenta accreta spectrum (PAS) disorders has risen over the last decades, and there has been a gradual shift towards expectant management. Conservative management of PAS is known to reduce major obstetric haemorrhage and salvage hysterectomy. There is a lack of consensu...

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Bibliographic Details
Published in:Case reports in obstetrics and gynecology 2020, Vol.2020 (2020), p.1-7
Main Authors: Herath, R. P., Amarasekara, A. M. A. K. G., Sanjeewa, J. M. P., Patabendige, M.
Format: Article
Language:English
Subjects:
Abdomen
Bladder
Blood transfusions
Case Report
Case reports
Femininity
Fertility
Fistula
Hysterectomy
Menstruation
Morbidity
Mortality
Obstetrics
Placenta
Pregnancy
Sepsis
Surgery
Ultrasonic imaging
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Summary:Background. The incidence of placenta accreta spectrum (PAS) disorders has risen over the last decades, and there has been a gradual shift towards expectant management. Conservative management of PAS is known to reduce major obstetric haemorrhage and salvage hysterectomy. There is a lack of consensus on the follow-up of patients undergoing conservative approaches. Here, we describe the follow-up of three patients with placenta percreta who were conservatively managed and review the literature for the conservative management of PAS. Case Presentation. We have successfully managed three cases of placenta percreta expectantly using combined methods involving symphysial-fundal height, serum beta-HCG, and ultrasonographic volume of placental mass. Conclusions. Use of a combined approach with symphysial-fundal height, serum beta-HCG, and ultrasonographic volume of placental mass with colour Doppler may guide the surveillance of these conservatively managed cases. However, at least one magnetic resonance imaging three months postoperatively may predict a further risk of delayed haemorrhage.
ISSN:2090-6684
2090-6692
DOI:10.1155/2020/9065342