• Grzegorz H Bręborowicz, Wiesław Markwitz, Michał Gaca, Agnieszka Koziołek, Mariola Ropacka-Lesiak, Anna Dera, Mariusz Brych, Marta Szymankiewicz-Bręborowicz, Grzegorz Kruszyński, Karolina Gruca-Stryjak, Mateusz Madejczyk, Agata Szpera-Goździewicz, and Mariola Krzyścin.
• Department of Perinatology and Gynecology, Poznan University of Medical Sciences, Poznań, Poland. gbrebor@wp.pl
• J. Matern. Fetal. Neonatal. Med. 2013 Jul 1; 26 (10): 1012-5.

ObjectiveAbnormal implantation of placenta previa is life-threatening condition. The purpose of this study was to evaluate the impact of the conservative management of pregnancies with such complication on maternal morbidity rate and the chance for uterine preservation (fertility).MethodsEleven patients with abnormal implantation of placenta previa were analyzed prospectively. This complication was diagnosed antenatally by two-dimensional ultrasound and color flow Doppler. The following outcomes were analyzed: need for blood transfusion, admission and duration of stay in intensive care unit, infections, coagulopathies, time between cesarean section and delivery of placenta, hysterectomy and preservation of uterus.ResultsAmong the 20 085 women who had a singleton gestation, 11 (0.054%) were identified with placenta previa with abnormal placentation. In five patients (group A), hysterectomy was performed because of hemorrhage or placenta ablation. In six patients (group B), conservative management succeeded and placenta were preserved. In group A, placenta were delivered earlier (2 d-8 weeks) in comparison with group B (6-15 weeks). Estimated blood loss during the delayed delivery of placenta was higher in the group with hysterectomy (respectively, 450-1600 and 300-500 ml).ConclusionsConservative management of placenta previa with abnormal implantation decreases the risk of severe hemorrhage at the time of delivery and can preserve fertility.

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