• Ann Acad Med Singap · Apr 2007

    Review Case Reports

    Lessons learnt from two women with morbidly adherent placentas and a review of literature.

    • Edwin W H Thia, Lay-Kok Tan, Kanagalingam Devendra, Tze-Tein Yong, Hak-Koon Tan, and Tew-Hong Ho.
    • Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore. edwintwh@gmail.com
    • Ann Acad Med Singap. 2007 Apr 1;36(4):298-303.

    IntroductionPathologically adherent placentas occur when there is a defect of the decidua basalis, typically arising from previous caesarean section, resulting in abnormally invasive implantation of the placenta. The depth of placental invasion varies from the superficial (accreta), to transmural and possibly beyond (percreta).Clinical PictureWe report on 2 cases, one treated "conservatively", the other with a caesarean hysterectomy, both of which led to a safe outcome for both mother and baby.ConclusionsManagement relies on accurate early diagnosis with appropriate perioperative multidisciplinary planning to anticipate and avoid massive obstetric haemorrhage at delivery.

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