Conservative Management of Placenta Percreta: Tunisian Prospective Study

Objective: To evaluate conservative management of placenta percreta and postoperative results.

Study design: In a prospective study we included all cases of placenta percreta diagnosed during pregnancy in the department of gynaecology and obstetrics B of university hospital of Charles Nicolle between 2011 and 2014. For these patients, conservative approach was attempted. In this procedure placenta was left in place until complete resorption.

Results: Thirteen patients with placenta percreta diagnosed in prenatal were identified. All patients were undergone conservative management. Median gestational age at delivery was 36 weeks. Prophylactic ligation of hypogastric was performed in 7 cases. No patient had blood transfusion in intraoperative. No patient had stayed in intensive cares. Postoperatively, four cases of endometritis occurred. A secondary hysterectomy was performed in 4 cases because of secondary haemorrhage. In 9 cases, there was complete involution of the placenta within a maximum period of 6 months.

Conclusion: In order to reduce morbidity and mortality in placenta percreta, conservative treatment is an interesting alternative especially if subsequent pregnancy desire. However, it exposes to infection and secondary bleeding, this risk requires a long follow up.

Author(s):

Nadia Ouerdiane, Walid Daaloul, Kaouther Othmani, Abdel Waheb Masmoudi, Sonia Ben Hamouda and Badreddine Bouguerra

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