Publicação
Placenta acreta
| Resumo: | Placenta acreta is a severe obstetric complication and one of the most frequent causes of peripartum hysterectomy, requiring a multidisciplinary approach for its management. The incidence of placenta acreta has increased over the last decades, in parallel with the increase in cesarean delivery rates. The main risk factor for placenta acreta is a previous cesarean delivery, particularly in case of a placenta previa overlying the cesarean scar.The diagnosis in a timely manner allows the planning of the delivery by a multidisciplinary team in a terciary hospital, in order to optimize both maternal and fetal outcomes. The diagnosis is usually made by ultrasound, although magnetic resonance imaging can be useful, especially in doubtful situations. In order to avoid an emergent cesarean the delivery should be scheduled between 34 and 35 weeks. The recommended treatment is an elective cesarean section and hysterectomy. Placenta should be left in situ, since attempts to removal it increase the risk of severe hemorrhage. In selected cases, conservative treatment may be considered in order to keep maternal fertility. |
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| Autores principais: | Hipólito, Ana Mafalda |
| Assunto: | Placenta acreta Centro terciário Equipa multidisciplinar Cesariana Histerectomia Hemorragia pós-parto |
| Ano: | 2014 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | português |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | Placenta acreta is a severe obstetric complication and one of the most frequent causes of peripartum hysterectomy, requiring a multidisciplinary approach for its management. The incidence of placenta acreta has increased over the last decades, in parallel with the increase in cesarean delivery rates. The main risk factor for placenta acreta is a previous cesarean delivery, particularly in case of a placenta previa overlying the cesarean scar.The diagnosis in a timely manner allows the planning of the delivery by a multidisciplinary team in a terciary hospital, in order to optimize both maternal and fetal outcomes. The diagnosis is usually made by ultrasound, although magnetic resonance imaging can be useful, especially in doubtful situations. In order to avoid an emergent cesarean the delivery should be scheduled between 34 and 35 weeks. The recommended treatment is an elective cesarean section and hysterectomy. Placenta should be left in situ, since attempts to removal it increase the risk of severe hemorrhage. In selected cases, conservative treatment may be considered in order to keep maternal fertility. |
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