Outcomes of subsequent pregnancies after conservative treatment for placenta accreta☆. Issue 2 (6th July 2014)

• Record Type: Journal Article
• Authors: Kabiri, Doron; Hants, Yael; Shanwetter, Neta; Simons, Moshe; Weiniger, Carolyn F.; Gielchinsky, Yuval; Ezra, Yossef
• Is Part Of: International journal of gynaecology and obstetrics. Volume 127:Issue 2(2014)
• Page Start: 206
• Page End: 210
• Publication Date: 2014-07-06
• Subjects: Adherent placenta -- Conservative treatment -- Placenta accreta -- Postpartum hemorrhage; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1016/j.ijgo.2014.05.013
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To estimate the association between conservative treatment for placenta accreta and subsequent pregnancy outcomes. Methods: In a retrospective study, data were analyzed on women who received conservative treatment for placenta accreta (removal of the placenta with uterine preservation) at a tertiary hospital in Jerusalem, Israel, between 1990 and 2000. Data were collected on subsequent pregnancies and neonatal outcomes until 2010, and compared with those from a matched control group of women who did not have placenta accreta. Results: A total of 134 women were included in both groups. Placenta accreta occurred in 62 (22.8%) of 272 subsequent deliveries in the study group for which data were available and 5 (1.9%) of 266 in the control group (relative risk [RR] 12.13; 95% confidence interval [CI] 4.95–29.69; P < 0.001). Early postpartum hemorrhage occurred in 23 (8.6%) of 268 deliveries in the study group and 7 (2.6%) of 268 in the control group (RR 3.29; 95% CI 1.43–7.53; P < 0.001). The odds ratio for recurrent placenta accreta in subsequent deliveries in the study group was 15.41 (95% CI 6.09–39.03; P < 0.001). Conclusion: Although subsequent pregnancies after conservative treatment for placenta accreta were mostly successful, the risk of recurrent placenta accreta and postpartum hemorrhage is high in future deliveries.