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PubMed2000

Placenta praevia and scarred uterus - an obstetrician's dilemma.

Three cases are presented here of patients who had placenta praevia following a previous caesarean section. All three patients had placenta accreta and developed severe postpartum haemorrhage necessitating total abdominal hysterectomy. We highlight the importance of being aware of the probability of severe haemorrhage due to placenta accreta in patients with placenta praevia following a previous caesarean operation.

Journal Article↗
PubMed1992

[Placenta praevia percreta with bladder invasion: a case report].

The authors report a rare case of placenta praevia percreta with bladder invasion giving rise to the need to carry out an emergency hysterectomy in order to stop the bleeding. The literature when analysed showed the possible outcome of this complication in a woman who had already had a caesarean section and who had placenta praevia that required a second caesarean. In this situation it is almost inevitable that a hysterectomy has to be carried out to stop the bleeding. The hysterectomy should be a total hysterectomy but this can be difficult because of the invariable "fusion" that takes place between the uterus and the posterior wall of the bladder. What has to the done bladder can range from simple closure of a hole in the bladder to ureteric diversion with reimplantation of the ureter depending on how badly the bladder has been invaded. In our case after a sub-total hysterectomy had been carried out with simple closure of the bladder, it was necessary to re-operate to treat a fistula between the bladder and the cervix.

Adult↗
PubMed1996

Placenta praevia accreta with delayed hysterectomy.

A case of placenta praevia accreta is described. Delivery was achieved by Caesarean section and the placenta was left in place because of the risk of haemorrhage. Successful internal iliac artery embolization was performed 9 days postpartum to control uterine bleeding. Hysterectomy was performed at 55 days postpartum because of bleeding and sepsis.

Adult↗
PubMed1989

Sex ratio and placenta praevia.

In the authors' Department, 144 cases of placenta praevia were treated in the course of 15 years. This number amounted to 0.54% of all births. The sex ratio of fetuses in association with this complication was 166.6, which exceeds that of all neonates during the same period of time. A preponderance of male babies was noted when the material was further analysed according to maternal age, parity and neonatal birth weight.

Adolescent↗
PubMed1992

Placenta praevia percreta invading the urinary bladder.

A case of placenta praevia percreta involving the urinary bladder is presented. A classical Caesarean section was performed at 35 weeks' gestation but the placenta was left in situ and an elective hysterectomy was successfully performed 2 weeks postpartum.

Adult↗
PubMed1989

[Use of partusisten in cases of placenta praevia and the incidence of respiratory distress syndrome in newborn infants].

Partusisten (Th 1165a, fenoterol) was given to 40 pregnant women aged from 19 to 39 years in whom ultrasonography demonstrated placenta praevia. Bleeding occurred between 21 and 36 weeks of pregnancy. The control group consisted of 44 pregnant women aged from 21 to 43 years not treated with partusisten. Bleeding in this group developed between 22 and 40 weeks of pregnancy. The authors conclude that partusisten use in cases of bleeding from placenta praevia in adequate doses and at adequate time make possible prolongation of pregnancy duration which increases the progression of lung maturation in the fetus and enabling reaching of relative biological maturity. This reduces the incidence of neonatal respiratory distress syndrome, and is the method of choice if genital bleeding develops prior to the 32nd week of pregnancy.

Adult↗
PubMed1984

Clinical usefulness of terbutaline in the management of placenta praevia.

Terbutaline was given to five patients with complete placenta praevia in order to prevent massive bleeding while at the same time prolonging the pregnancy. The longest period gained on therapy was 48 days and the shortest was 6 days. Doses of terbutaline used in these periods were 0.71-4.47 mg/dl. No serious complications were observed.

Adult↗
PubMed2000

Anaesthesia for emergency caesarean section in a parturient with bleeding placenta praevia and a potentially malignant hyperthermia-susceptible fetus.

A parturient who was 35 weeks' pregnant by her husband who was known to be susceptible to malignant hyperthermia, required anaesthesia for caesarean section for bleeding placenta praevia. The patient was considered to be haemodynamically stable and the procedure was carried out uneventfully under subarachnoid block. Anaesthesia was conducted as for an individual who is susceptible to malignant hyperthermia. The combination of the potential susceptibility to malignant hyperthermia of the fetus, and the problems of bleeding placenta praevia, produced an unusual clinical situation with potential conflict of interests when choosing the anaesthetic technique.

Journal Article↗
PubMed2006

[Placenta praevia percreta with bladder invasion: a life-threatening pregnancy complication].

Placenta percreta is characterized by the penetration of trophoblast through the myometrium and peritoneum. This invasion may also involve adjacent structures. This condition is the most serious of placental implantation anomalies. It is a rare but life-threatening complication of pregnancy. We present a case of placenta praevia percreta with involvement of the bladder, discuss the particularities of the diagnosis and management, and review the literature.

Adult↗
PubMed1994

[Prenatal diagnosis of a placenta praevia percreta with color Doppler. A case report. Review of the literature].

Placenta praevia percreta, with bladder invasion, was diagnosed at 29 weeks of amenorrhoea with colour Doppler which visualized vascular bundles leaving the placenta and reaching the lower part of the bladder. These bundles were identified as including arterial elements with pulsed Doppler. The criteria for the diagnosis of placenta accreta with ultrasonography and colour Doppler have been presented in the literature. This prenatal diagnosis allowed adapted preoperative management and intensive care, however air embolism could not be avoided and the patient died at the end of the operation.

Adult↗
PubMed2005

Coping with placenta praevia and accreta in a DGH setting and words of caution.

The incidence of placenta praevia and accreta has been increasing with rising caesarean section rates. We highlight the increasing incidence of severe post-partum haemorrhage due to placenta accreta. Four cases occurred within 3 years (2002--2004) in a small District General Hospital (DGH) with a delivery rate of 1,800 per year. All of the cases had previous caesarean sections and three had an associated anterior low-lying placenta. These patients were diagnosed to have placenta accreta in the third stage of labour, as the placenta was completely adherent and was difficult to remove. However, two of them had a provisional diagnosis made of placenta accreta and prophylactic measures had been taken in the form of counselling and consent for possible hysterectomy. Patients were counselled regarding this condition, and the possible need for hysterectomy was discussed. Two of them had to be managed by post-partum hysterectomy and the other two were treated conservatively. The purpose of writing these case reports is to warn others of the need for vigilance, particularly in keeping their primary caesarean section rates down and being prepared for long-term complications.

Adult↗
PubMed1993

[A seldom used method of conservative treatment for hemorrhage in a pregnant patient with placenta praevia centralis].

The subject described is the method of conservative treatment in the case of the placenta praevia cervicalis. Bilateral ligation of the ramus descensus arteriae uterinae together with the tamponing of the uterus cervix can be effective in staunching hemorrhages caused by the inability to separate the placenta implanted in the muscular tissue of the cervix. Due to the remaining fragments of the placenta, it is necessary to test the solution of HCG in the serum. The described method of treatment allows the sex organ to be left intact.

Adult↗