A Clinical Study of Placental Adhesions: Placenta Accreta, Placenta Increta, and Placenta Percreta.
- Author:
Young Hoon SUH
1
;
Eun Ho SONG
;
Dong Hee KIM
;
Yeon Hee LEE
;
Hye Young PARK
;
Kyung Sim KOH
;
Choong Hak PARK
Author Information
1. Department of Obstetrics and Gynecology, Dankook University College of Medicine, Cheonan, Korea.
- Publication Type:Original Article
- Keywords:
Placental adhesions;
Placenta accreta;
Placenta increta;
Placenta percreta
- MeSH:
Academic Medical Centers;
Disseminated Intravascular Coagulation;
Fetal Death;
Fever;
Gravidity;
Hysterectomy;
Incidence;
Medical Records;
Placenta Accreta*;
Placenta Previa;
Placenta*;
Pleural Effusion;
Premature Birth;
Pulmonary Edema;
Ulcer;
Urinary Bladder;
Uterine Hemorrhage;
Wound Infection
- From:Korean Journal of Obstetrics and Gynecology
2003;46(1):81-88
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: The objective of this study is to investigate the clinical characteristics of placental adhesions in order to improve maternal and fetal well-beings. METHODS: We reviewed the medical records of twenty cases of placental adhesions from January 1, 1995 to December 31, 1999 in Dankook University Medical Center. RESULTS: The incidence of placental adhesions is 0.267%. Of them, the percentage of placenta accreta was 35%, placenta increta, 60% and placenta percreta, 5%. Placental adhesions were observed more often in multipara (80%) than nullipara (20%). Co-existing placenta previa (50%), previous cesarean delivery (40%), multigravidity (5 or more; 40%) and previous artificial abortion (70%) were associated with placental adhesions. 85% of placental adhesions were treated by hysterectomy in order to manage postpartal uterine bleeding. Packed red cell transfusions were necessary in 18 cases of placental adhesions (90%). Maternal complications were wound infection (10%), disseminated intravascular coagulation, throm- boembolism, stress ulcer, postoperative fever, bladder perforation, pulmonary edema, and pleural effusion etc. Fetal complications were preterm birth (30%), neonatal death (5%), and fetal death in utero (10%). CONCLUSION: This study revealed that placental adhesions show grave maternal and fetal complications. Obstetricians should examine carefully to confirm placental adhesions and prepare thoroughly the postpartal emergency-care, especially in the high-risk gravida.
