Unit:
ΠΜΣ Παθολογία της ΚύησηςLibrary of the School of Health Sciences
Supervisors info:
Νικόλαος Παπαντωνίου, Ομότιμος Καθηγητής, Ιατρική, ΕΚΠΑ
Δημήτριος Κασσάνος, Ομότιμος Καθηγητής, Ιατρική, ΕΚΠΑ
Χαράλαμπος Χρέλιας, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Original Title:
Διαταραχές φάσματος διεισδυτικού πλακούντα - Σύγχρονη θεραπευτική αντιμετώπιση
Translated title:
Placenta accreta spectrum disorders - Current treatment
Summary:
Introduction
This study focuses on the excellent but complex process of placentation and it's deviation from the normal restriction pathways that lead to abnormal invasive placentation.
Purpose - Materials and Method
The purpose of this study is to educate the obstetric care providers, with the epidemiology, risk factors, the histologic and clinical diagnosis and management of these disorders according to new data, reviews, meta-analyses and guidelines from the world's finest obstetric societies. The printed and online literature was reviewed, searching for manifestations of epidemiology, risk factors , prenatal diagnosis, non conservative surgical and conservative management of PAS disorders, with pros and cons and complication analysis. The results were analysed and this study was composed and based on them.
Conclusions
As the incidence of cesarean deliveries have increased, placenta accretaalso has increased and is an important cause of maternal and fetal/neonatal morbidity and mortality. Placenta accreta occurs due to abnormal adherence of the placenta to the myometrium instead of the decidua during the first trimister of pregnancy. In patients at risk for accreta, obstetric ultrasonography performed by an experienced provider should be obtained and standarized description and name for all the ultrasound signs used for the prenatal diagnosis of placenta accreta should be held, in an attempt to reduce errors due to the subjectivity involved in making the diagnosis A multidisciplinary team in a center with expertise in managing placenta accreta should care for cases of suspected accreta. Additional research is needed to identify optimal methods of secondary prevention, alternative modalities for diagnosis, surgical techniques and appropriate conservative management strategies.
Main subject category:
Health Sciences
Keywords:
Abnormal placentation, Accreta, Increta, Percreta, Placenta, Hemorrhage, Cesarean hysterectomy, Indicated preterm delivery
Number of references:
400
