Planned conservative management of placenta accreta – experience of a regional general hospital
Lo TK1, Yung WK1, Lau WL1, Law B2, Lau S3, Leung WC1
1Department of Obstetrics & Gynecology, 2Department of Anesthesiology, and 3Department of Radiology, Kwong Wah Hospital, HKSAR, China
OBJECTIVE: There are only a few series treating ≥10 cases of accreta conservatively, all from university teaching hospitals, with reported success rate 60-85%. We reported the first series of accreta managed by planned uterine conservation in the setting of non-university district general hospital.
METHODS: Women with placenta previa overlying previous cesarean scar who desired uterine conservation were included. For cases with accreta confirmed during caesarean delivery, placenta was purposefully left behind, followed immediately by uterine artery embolization in operating theater. Modified B-Lynch sutures were used for atonic hemorrhage not responding to uterotonics. Cases were followed till sonographic resolution of placenta. Charts were reviewed to retrieve clinical details.
CONCLUSION: Placenta accreta can be managed conservatively with good outcomes in the setting of district general hospital with facilities for interventional radiology.