International journal of gynaecology and obstetrics : the official organ of the International Federation of Gynaecology and Obstetrics
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Int J Gynaecol Obstet · Mar 2018
Comparative StudyLeaving the placenta in situ versus conservative and radical surgery in the treatment of placenta accreta spectrum disorders.
To compare different treatment methods in the management of placenta accreta spectrum (PAS) disorders. ⋯ Leaving the placenta in situ could become the treatment of choice for PAS disorders.
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Int J Gynaecol Obstet · Mar 2018
Retrospective analysis of obstetric and anesthetic management of patients with placenta accreta spectrum disorders.
To assess the management and maternal outcomes of placenta accreta spectrum (PAS) disorders. ⋯ Placenta previa and accreta coexist in many patients, leading to substantial bleeding related to the degree of myometrial invasion. An interdisciplinary team approach plus the use of combined spinal-epidural anesthesia, transitioning to general anesthesia, were advisable and safe.
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Int J Gynaecol Obstet · Mar 2018
Observational StudyThe importance of bladder volume in the ultrasound diagnosis of placenta accreta spectrum disorders.
To assess how a quantifiable measure of vascularity-i.e. abnormal confluence (Acon ) in the subplacental myometrium observed by three-dimensional power-Doppler ultrasonography-changes with different bladder volumes. ⋯ Objective evidence was found for a quantifiable difference in vascularity in the myometrium with bladder volume among women with PAS disorders. This difference has sufficient magnitude to influence the potential of Acon as a diagnostic marker.
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Int J Gynaecol Obstet · Mar 2018
Interobserver agreement on standardized ultrasound and histopathologic signs for the prenatal diagnosis of placenta accreta spectrum disorders.
To evaluate interobserver agreement in assessment of ultrasound signs and histopathologic findings associated with placenta accreta spectrum (PAS) disorders. ⋯ Standardized ultrasound signs might prove useful for prenatal screening of women at risk of PAS disorders and should enable remote evaluation of images when PAS is suspected.
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To review a single-center case series of placenta percreta and to evaluate risk factors and the impact of surgical techniques used in previous cesarean delivery. ⋯ The prenatal ultrasonography diagnosis of placenta percreta is accurate and facilitates optimal management by a specialized multidisciplinary team. Multicenter studies are required to further evaluate the impact of the surgical techniques used for prior cesarean delivery on the risks of placenta percreta in subsequent pregnancies.