Publication:

Multistep approach for control of postpartum hemorrhage in placenta accreta: a novel scheme in a tertiary referral center

Background Placenta accreta is a major cause for massive postpartum hemorrhage and consequent obstetric hysterectomy. Incidence is rising secondary to increased rates of caesarian delivery worldwide.

Methods From January 2014 to January 2016, 25 women with anterior low-lying placenta and previous caesarian section(s) were recruited at El-Shatby Maternity university hospital in Alexandria, Egypt.  Cases had previous 1-4 lower segment caesarian deliveries. Cases were diagnosed as placenta accreta by ultrasonographic examination on admission to hospital. Elective surgery was done at 36-37 weeks. Mid line abdominal incision with upper segment uterine incision with plication of lowers uterine segment with transverse compression sutures.

Results We present a clinical trial for conservative management of placenta accreta in 25 cases with 19 cases [76%] successfully managed without hysterectomy.

Conclusions Conservative management of placenta accreta can be successfully performed in young age females desiring fertility.