Open AccessSurgical uterine devascularization for placenta accreta: immediate and long‐term follow‐up
Author(s) -
Verspyck Eric,
Resch Benoit,
Sergent Fabrice,
Marpeau Loïc
Publication year - 2005
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.0001-6349.2005.00504.x
Subject(s) - medicine , placenta accreta , placenta previa , hysterectomy , pregnancy , obstetrics , placenta , uterus , menstruation , gynecology , surgery , fetus , genetics , biology
Background. To report immediate and long‐term outcome in patients with surgical uterine devascularization for placenta accreta. Methods. Six patients with placenta accreta were treated conservatively during a cesarean section by a bilateral uterine and ovarian surgical devascularization procedure. Menstrual flow, imaging monitoring and further pregnancy were retrospectively reported. Results. Blood transfusion was necessary in five cases and a hysterectomy was performed in one patient with placenta previa accreta. All patients resumed menstruation without oral contraception but one of them reported temporary clinical symptoms of estrogen insufficiency. A chronic placental retention occurred in three patients with incomplete placenta removal. One patient with both bilateral uterine and ovarian arterial ligations had a subsequent pregnancy complicated by a recurrent placenta accreta that was subsequently treated conservatively. Conclusions. Surgical uterine devascularization for placenta accreta may be useful for uterine conservation. However, reproductive capacity may be altered by placental chronic retention and further pregnancies may be complicated by recurrent placenta accreta.