Epidemiology, etiology, diagnosis, and management of placenta accreta

Gali Garmi, Raed Salim, Gali Garmi, Raed Salim

Abstract

Placenta accreta is a severe pregnancy complication and is currently the most common indication for peripartum hysterectomy. It is becoming an increasingly common complication mainly due to the increasing rate of cesarean delivery. Main risk factor for placenta accreta is a previous cesarean delivery particularly when accompanied with a coexisting placenta previa. Antenatal diagnosis seems to be a key factor in optimizing maternal outcome. Diagnosis can be achieved by ultrasound in the majority of cases. Women with placenta accreta are usually delivered by a cesarean section. In order to avoid an emergency cesarean and to minimize complications of prematurity it is acceptable to schedule cesarean at 34 to 35 weeks. A multidisciplinary team approach and delivery at a center with adequate resources, including those for massive transfusion are both essential to reduce neonatal and maternal morbidity and mortality. The optimal management after delivery of the neonate is vague since randomized controlled trials and large cohort studies are lacking. Cesarean hysterectomy is probably the preferable treatment. In carefully selected cases, when fertility is desired, conservative management may be considered with caution. The current review discusses the epidemiology, predisposing factors, pathogenesis, diagnostic methods, clinical implications and management options of this condition.

References

    1. Tan CH, Tay KH, Sheah K, et al. Perioperative endovascular internal iliac artery occlusion balloon placement in management of placenta accreta. American Journal of Roentgenology. 2007;189(5):1158–1163.
    1. Faranesh R, Shabtai R, Eliezer S, Raed S. Suggested approach for management of placenta percreta invading the urinary bladder. Obstetrics and Gynecology. 2007;110(2):512–515.
    1. Daskalakis G, Anastasakis E, Papantoniou N, Mesogitis S, Theodora M, Antsaklis A. Emergency obstetric hysterectomy. Acta Obstetricia et Gynecologica Scandinavica. 2007;86(2):223–227.
    1. Hudon L, Belfort MA, Broome DR. Diagnosis and management of placenta percreta: a review. Obstetrical and Gynecological Survey. 1998;53(8):509–517.
    1. O’Brien JM, Barton JR, Donaldson ES. The management of placenta percreta: conservative and operative strategies. American Journal of Obstetrics and Gynecology. 1996;175(6):1632–1638.
    1. Sumigama S, Itakura A, Ota T, et al. Placenta previa increta/percreta in Japan: a retrospective study of ultrasound findings, management and clinical course. Journal of Obstetrics and Gynaecology Research. 2007;33(5):606–611.
    1. Eller AG, Porter TT, Soisson P, Silver RM. Optimal management strategies for placenta accreta. An International Journal of Obstetrics and Gynaecology. 2009;116(5):648–654.
    1. Hamilton BE, Martin JA, Ventura SJ, Sutton PD, Menacker F. Births: preliminary data for 2004. National vital Statistics Reports. 2005;54(8):1–17.
    1. Warshak CR, Ramos GA, Eskander R, et al. Effect of predelivery diagnosis in 99 consecutive cases of placenta accreta. Obstetrics and Gynecology. 2010;115(1):65–69.
    1. Wu S, Kocherginsky M, Hibbard JU. Abnormal placentation: twenty-year analysis. American Journal of Obstetrics and Gynecology. 2005;192(5):1458–1461.
    1. Miller DA, Chollet JA, Goodwin TM. Clinical risk factors for placenta previa-placenta accreta. American Journal of Obstetrics and Gynecology. 1997;177(1):210–214.
    1. Clark SL, Koonings PP, Phelan JP. Placenta previa/accreta and prior cesarean section. Obstetrics and Gynecology. 1985;66(1):89–92.
    1. Gielchinsky Y, Rojansky N, Fasouliotis SJ, Ezra Y. Placenta accreta—summary of 10 years: a survey of 310 cases. Placenta. 2002;23(2-3):210–214.
    1. Sivan E, Spira M, Achiron R, et al. Prophylactic pelvic artery catheterization and embolization in women with placenta accreta: can it prevent cesarean hysterectomy? American Journal of Perinatology. 2010;27(6):455–461.
    1. Garmi G, Goldman S, Shalev E, Salim R. The effects of decidual injury on the invasion potential of trophoblastic cells. Obstetrics and Gynecology. 2011;117(1):55–59.
    1. Tantbirojn P, Crum CP, Parast MM. Pathophysiology of placenta creta: the role of decidua and extravillous trophoblast. Placenta. 2008;29(7):639–645.
    1. Alkazaleh F, Geary M, Kingdom J, Kachura JR, Windrim R. Elective non-removal of the placenta and prophylactic uterine artery embolization postpartum as a diagnostic imaging approach for the management of placenta percreta: a case report. Journal of Obstetrics and Gynaecology Canada. 2004;26(8):743–746.
    1. Committee on Obstetric Practice American College of Obstetricians and Gynecologists. ACOG committee opinion. Placenta accreta. Number 266, January 2002. International Journal of Gynecology and Obstetrics. 2002;77(1):77–78.
    1. Oyelese Y, Smulian JC. Placenta previa, placenta accreta, and vasa previa. Obstetrics and Gynecology. 2006;107(4):927–941.
    1. Kayem G, Davy C, Goffinet F, Thomas C, Cléent D, Cabrol D. Conservative versus extirpative management in cases of placenta accreta. Obstetrics and Gynecology. 2004;104(3):531–536.
    1. Timmermans S, Van Hof AC, Duvekot JJ. Conservative management of abnormally invasive placentation. Obstetrical and Gynecological Survey. 2007;62(8):529–539.
    1. Hung TH, Shau WY, Hsieh CC, Chiu TH, Hsu JJ, Hsieh TT. Risk factors for placenta accreta. Obstetrics and Gynecology. 1999;93(4):545–550.
    1. Washecka R, Behling A. Urologic complications of placenta percreta invading the urinary bladder: a case report and review of the literature. Hawaii Medical Journal. 2002;61(4):66–69.
    1. Armstrong CA, Harding S, Matthews T, Dickinson JE. Is placenta accreta catching up with us? Australian and New Zealand Journal of Obstetrics and Gynaecology. 2004;44(3):210–213.
    1. Alanis M, Hurst BS, Marshburn PB, Matthews ML. Conservative management of placenta increta with selective arterial embolization preserves future fertility and results in a favorable outcome in subsequent pregnancies. Fertility and Sterility. 2006;86(5):1514.e3–1514.e7.
    1. Benirschke K, Kaufmann P, Baergen RN. Pathology of the Human Placenta. 5th edition. New York, NY, USA: Springer; 2006.
    1. Tseng J-J, Chou M-M. Differential expression of growth-, angiogenesis- and invasion-related factors in the development of placenta accreta. Taiwanese Journal of Obstetrics and Gynecology. 2006;45(2):100–106.
    1. Cohen M, Wuillemin C, Irion O, Bischof P. Role of decidua in trophoblastic invasion. Neuroendocrinology Letters. 2010;31(2):193–197.
    1. Earl U, Bulmer JN, Briones A. Placenta accreta: an immunohistological study of trophoblast populations. Placenta. 1987;8(3):273–282.
    1. Comstock CH. Antenatal diagnosis of placenta accreta: a review. Ultrasound in Obstetrics and Gynecology. 2005;26(1):89–96.
    1. Belfort MA. Placenta accrete. American Journal of Obstetrics & Gynecology. 2010;203:430–439.
    1. Wong HS, Ying KC, Zuccollo J, Tait J, Pringle KC. Evaluation of sonographic diagnostic criteria for placenta accreta. Journal of Clinical Ultrasound. 2008;36(9):551–559.
    1. Shih JC, Jaraquemada JMP, Su YN, et al. Role of three-dimensional power Doppler in the antenatal diagnosis of placenta accreta: comparison with gray-scale and color Doppler techniques. Ultrasound in Obstetrics and Gynecology. 2009;33(2):193–203.
    1. Levine D, Hulka CA, Ludmir J, Li W, Edelman RR. Placenta accreta: evaluation with color Doppler US, power Doppler US, and MR imaging. Radiology. 1997;205(3):773–776.
    1. Zelop C, Nadel A, Frigoletto FD, Pauker S, MacMillan M, Benacerraf BR. Placenta accreta/percreta/increta: a cause of elevated maternal serum alpha-fetoprotein. Obstetrics and Gynecology. 1992;80(4):693–694.
    1. Mazouni C, Gorincour G, Juhan V, Bretelle F. Placenta accreta: a review of current advances in prenatal diagnosis. Placenta. 2007;28(7):599–603.
    1. Tantbirojn P, Crum CP, Parast MM. Pathophysiology of placenta creta: the role of decidua and extravillous trophoblast. Placenta. 2008;29(7):639–645.
    1. Eller AG, Bennett MA, Sharshiner M, et al. Maternal morbidity in cases of placenta accreta managed by a multidisciplinary care team compared with standard obstetric care. Obstetrics and Gynecology. 2011;117(2):331–337.
    1. Robinson BK, Grobman WA. Effectiveness of timing strategies for delivery of individuals with placenta previa and accreta. Obstetrics and Gynecology. 2010;116(4):835–842.
    1. Hawkins JL, Arens JF, Bucklin BA, et al. Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task Force on obstetric anesthesia. Anesthesiology. 2007;106(4):843–863.
    1. Chestnut DH, Dewan DM, Redick LF, Caton D, Spielman FJ. Anesthetic management for obstetric hysterectomy: a multi-institutional study. Anesthesiology. 1989;70(4):607–610.
    1. Kuczkowski KM. Anesthesia for the repeat cesarean section in the parturient with abnormal placentation: what does an obstetrician need to know? Archives of Gynecology and Obstetrics. 2006;273(6):319–321.
    1. Eller AG, Porter TT, Soisson P, Silver RM. Optimal management strategies for placenta accreta. An International Journal of Obstetrics and Gynaecology. 2009;116(5):648–654.
    1. Read JA, Cotton DB, Miller FC. Placenta accreta: changing clinical aspects and outcome. Obstetrics and Gynecology. 1980;56(1):31–34.
    1. Clouqueur E, Rubod C, Paquin A, Devisme L, Deruelle P. Placenta accreta: diagnosis and management in a French high-level maternity. Journal de Gynecologie Obstetrique et Biologie de la Reproduction. 2008;37(5):499–504.
    1. Kayem G, Davy C, Goffinet F, Thomas C, Cléent D, Cabrol D. Conservative versus extirpative management in cases of placenta accreta. Obstetrics and Gynecology. 2004;104(3):531–536.
    1. Weinstein A, Chandra P, Schiavello H, Fleischer A. Conservative management of placenta previa percreta in a Jehovah’s Witness. Obstetrics and Gynecology. 2005;105(5):1247–1250.
    1. Henrich W, Fuchs I, Ehrenstein T, Kjos S, Schmider A, Dudenhausen JW. Antenatal diagnosis of placenta percreta with planned in situ retention and methotrexate therapy in a woman infected with HIV. Ultrasound in Obstetrics and Gynecology. 2002;20(1):90–93.
    1. Sentilhes L, Ambroselli C, Kayem G, et al. Maternal outcome after conservative treatment of placenta accreta. Obstetrics and Gynecology. 2010;115(3):526–534.
    1. Sentilhes L, Kayem G, Ambroselli C, et al. Fertility and pregnancy outcomes following conservative treatment for placenta accreta. Human Reproduction. 2010;25(11):2803–2810.
    1. Paull JD, Smith J, Williams L, Davison G, Devine T, Holt M. Balloon occlusion of the abdominal aorta during caesarean hysterectomy for placenta percreta. Anaesthesia and Intensive Care. 1995;23(6):731–734.
    1. Salim R, Zafran N, Chulski A, Shalev E. Employing a balloon catheter for occlusion and/or embolization of the pelvic vasculature as an adjuvant therapy in cases of abnormal placentation. Harefuah. 2010;149(6):370–403.
    1. Dubois J, Garel L, Grignon A, Lemay M, Leduc L. Placenta percreta: balloon occlusion and embolization of the internal iliac arteries to reduce intraoperative blood losses. American Journal of Obstetrics and Gynecology. 1997;176(3):723–726.
    1. Chou MM, Hwang JI, Tseng JJ, Ho ESC. Internal iliac artery embolization before hysterectomy for placenta accreta. Journal of Vascular and Interventional Radiology. 2003;14(9):1195–1199.
    1. Kidney DD, Nguyen AM, Ahdoot D, Bickmore D, Deutsch LS, Majors C. Prophylactic perioperative hypogastric artery balloon occlusion in abnormal placentation. American Journal of Roentgenology. 2001;176(6):1521–1524.
    1. Bodner LJ, Nosher JL, Gribbin C, Siegel RL, Beale S, Scorza W. Balloon-assisted occlusion of the internal iliac arteries in patients with placenta accreta/percreta. CardioVascular and Interventional Radiology. 2006;29(3):354–361.
    1. Shrivastava V, Nageotte M, Major C, Haydon M, Wing D. Case-control comparison of cesarean hysterectomy with and without prophylactic placement of intravascular balloon catheters for placenta accreta. American Journal of Obstetrics and Gynecology. 2007;197(4):402.e1–402.e5.
    1. Mok M, Heidemann B, Dundas K, Gillespie I, Clark V. Interventional radiology in women with suspected placenta accreta undergoing caesarean section. International Journal of Obstetric Anesthesia. 2008;17(3):255–261.

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