Urologic Considerations of Placenta Accreta: A Contemporary Tertiary Care Institutional Experience

作者：Woldu Solomon L^*; Ordonez Maria A; Devine Patricia C; Wright Jason D

来源：Urologia Internationalis, 2014, 93(1): 74-79.

DOI：10.1159/000356064

• Female
• Trauma
• Urogynecology
• Placenta accreta
• Obstetrics

Background: As the incidence of cesarean delivery has increased, we are experiencing a higher incidence of subsequent placenta accreta and the associated complications, including urologic complications. Methods:This is a retrospective review of all patients delivered from 2000 to 2011 with a histologically proven diagnosis of placenta accreta. Data were analyzed for baseline maternal characteristics, intraoperative and postoperative outcomes and complications. Results: 83 patients were included in the analysis. The depth of placenta accreta invasion varied in the cohort, with 48, 25 and 27% being classified as placenta accreta, placenta increta and placenta percreta, respectively. 88% of patients had had a previous cesarean delivery, and 58% had more than one prior operative delivery. Cystotomy was encountered in 27% of patients and ureteral injury occurred in 4%. Degree of placenta accreta invasion, number of prior cesarean deliveries and intraoperative blood loss were associated with a higher likelihood of urologic injury. Conclusions: Urologic injuries are among the most frequently encountered intraoperative complications of placenta accreta. Surgeons involved in these cases need to be aware of this risk and maintain a high level of surveillance intraoperatively.

• 出版日期2014