1.Lessons learnt from two women with morbidly adherent placentas and a review of literature.
Edwin W H THIA ; Lay-Kok TAN ; Kanagalingam DEVENDRA ; Tze-Tein YONG ; Hak-Koon TAN ; Tew-Hong HO
Annals of the Academy of Medicine, Singapore 2007;36(4):298-303
INTRODUCTIONPathologically adherent placentas occur when there is a defect of the decidua basalis, typically arising from previous caesarean section, resulting in abnormally invasive implantation of the placenta. The depth of placental invasion varies from the superficial (accreta), to transmural and possibly beyond (percreta).
CLINICAL PICTUREWe report on 2 cases, one treated "conservatively", the other with a caesarean hysterectomy, both of which led to a safe outcome for both mother and baby.
CONCLUSIONSManagement relies on accurate early diagnosis with appropriate perioperative multidisciplinary planning to anticipate and avoid massive obstetric haemorrhage at delivery.
Adult ; Cesarean Section ; adverse effects ; utilization ; Decidua ; abnormalities ; Female ; Humans ; Hysterectomy ; Incidence ; Magnetic Resonance Imaging ; Placenta ; abnormalities ; diagnostic imaging ; Placenta Accreta ; diagnosis ; epidemiology ; etiology ; physiopathology ; Pregnancy ; Thailand ; epidemiology ; Ultrasonography ; Uterine Hemorrhage ; etiology
2.Caesarean section scar pregnancy: a case series at a single tertiary centre.
Yi Ping Cindy PANG ; Wei Ching TAN ; Tze Tein YONG ; Poh Kim Elisa KOH ; Hak Koon TAN ; Tew Hong HO
Singapore medical journal 2012;53(10):638-642
We present a case series of four patients with Caesarean scar pregnancies (CSPs) managed at our gynaecological unit between October 2008 and May 2009. Three patients were detected while asymptomatic, and were treated with elective intragestational sac methotrexate injections. The last patient had presented following complications from a termination of pregnancy for a CSP that was misdiagnosed as intrauterine. Following treatment, this patient and another developed arteriovenous malformation, which responded to bilateral uterine artery embolisations and gonadotropin releasing hormone (GnRH)-agonist treatment.
Abortion, Induced
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methods
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Adult
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Cesarean Section
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adverse effects
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Cicatrix
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complications
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Female
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Humans
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Magnetic Resonance Imaging
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Pregnancy
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Pregnancy, Ectopic
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diagnosis
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etiology
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therapy
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Treatment Outcome