BJOG : an international journal of obstetrics and gynaecology
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Abnromalities of placentation, including placenta accreta, represent a major source of morbidity and mortality among women. Traditional management consists of peripartum hysterectomy at the time of delivery, although more conservative treatments have also been developed recently. In this review we describe the available literature describing the operative approach and considerations for management of women with placenta accreta.
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Randomized Controlled Trial
Twelve-year follow-up of conservative management of postnatal urinary and faecal incontinence and prolapse outcomes: randomised controlled trial.
To determine the long-term (12-year) effects of a conservative nurse-led intervention for postnatal urinary incontinence. ⋯ The moderate short-term benefits of a brief nurse-led conservative treatment for postnatal urinary incontinence did not persist. About four-fifths of women with urinary incontinence 3 months after childbirth still had this problem 12 years later.
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Observational Study
The management and outcomes of placenta accreta, increta, and percreta in the UK: a population-based descriptive study.
To describe the management and outcomes of placenta accreta, increta, and percreta in the UK. ⋯ Women with placenta accreta, increta, or percreta who have no attempt to remove any of their placenta, with the aim of conserving their uterus, or prior to hysterectomy, have reduced levels of haemorrhage and a reduced need for blood transfusion, supporting the recommendation of this practice.
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To compare the difference in risks of neonatal and maternal complications, including uterine rupture, in a second birth following a planned caesarean section versus emergency caesarean section in the first birth. ⋯ We found a moderately increased risk of postpartum haemorrhage and a small to moderately increased risk of uterine rupture and stillbirth as a long-term effect of prior planned caesarean delivery on second births.
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To explore the risk of adverse maternal and perinatal outcomes in women with antepartum bleeding of unknown origin (ABUO). ⋯ Pregnancies complicated by ABUO are at a greater risk of preterm delivery and induced labour. There was no increase seen in perinatal mortality after adjusting for preterm birth.