Prevention of massive bleeding due to placenta accreta

Baranouskaya E.I.

doi:https://doi.org/10.17116/rosakush20212101184

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Abstract:

The term placenta accreta describes a spectrum of placenta invasion disorders — placenta accreta, increta, percreta. Massive bleeding is a serious complication of placenta accreta, which might be avoided with antenatal diagnostic tests using effective modern technologies. If we suspect placenta accreta, a caesarean section should be done in a tertiary or quaternary care hospital with multidisciplinary qualified team. Planned intervention is performed in case of stable status of mother and fetus, 36—37 weeks is preferable term. The choice of surgical or conservative treatment of placenta accreta depends on the depth of invasion, the patient’s persistent desire to maintain reproductive function. FIGO experts recommend a hysterectomy performed during caesarean section. Preventive method of massive bleeding is a balloon aortic occlusion during hysterectomy or a resection of the uterine wall promptly after cesarean section, and uterine artery embolization regarding to conservative treatment of patients with placenta in situ to effective reducing uterine blood supply.

Keywords:

pregnancy

placenta accrete

cesarean section

bleeding

embolization

arterial balloon occlusion

Authors:

Baranouskaya E.I.

Belarusian State Medical University

Received:

19.06.2020

Accepted:

10.07.2020

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References:

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