HEALTH OF WOMAN. 2016.5(111):84–86 
 

Placenta increta, treatments

Demenina N. K., Ishenko A. I., Milievskyi A. V.

SI «Institute of Pediatrics, Obstetrics and Gynecology, NAMS of Ukraine», Kiev

Placenta increta is an effect of abnormal implantation in decidua or into the myometrium. This condition is very rare in obstetric practice, but it is associated with about 7% of deaths among pregnant women. The pathology of placenta complicates, according to different sources, 1/533 to 1/40 000 pregnancies. Due to the increasing number of cesarean section number of increta placenta grows also. Pathogenesis of placenta increta is still completely unknown. Diagnosis and treatment are an important clinical problem. Conservative treatment depends on the administration of methotrexate in a variety of doses and hysterectomy. Since there is no standard protocol of clinical treatment every qualification to this type of treatment should be considered carefully.

Key words: placenta increta, pathogenesis, diagnosis, conservative treatment, methotrexate, hysterectomy, bleeding, pregnancy.

REFERENCES

1. ACOG Committee Opinion. Placenta accreta. Number 529, July 2012. American College of Obstetricians and Gynaecologists. Obstet Gynecol 2012. 120:207–211. PMid:22914422

2. Angstmann T, Gard G, Harrington T et al. 2010. Surgical management of placenta accreta: a cohort series and suggested approach. Am. J. Obstet. Gynecol. 202:38–39. http://dx.doi.org/10.1016/j.ajog.2009.08.037; PMid:19922901

3. Arulkumaran S, Ng CS, Ingemarsson I et al. 1986. Medical treatment of placenta accreta with methotrexate. Acta Obstet. Gynecol. Scand. 65;3:285–286. http://dx.doi.org/10.3109/00016348609155187

4. Berchuck A, Sokol RJ. 1983. Previous cesarean section, placenta increta, and uterine rupture in second-trimester abortion. Am J Obstet Gynecol 145:766–767. http://dx.doi.org/10.1016/0002-9378(83)90591-4

5. Breen JL, Neubecker R, Gregori CA, Franklin JE Jr. 1977. Placenta accreta, increta, and percreta. A survey of 40 cases. Obstet Gynecol 49:43–47. PMid:299782

6. Brown BJ, Heaston DK, Poulson AM, Gabert HA, Mineau DE, Miller FJ Jr. 1979. Uncontrollable postpartum bleeding: a new approach to hemostasis through angiographic arterial embolization. Obstet Gynecol 54:361–365. PMid:314075

7. Chan BCP, Lam HSW, Yuen JHF et al. 2008. Conservative management of placenta previa with accrete. Hong Kong Med. J. 14:479–484. PMid:19060348

8. Committee on Obstetric Practice. ACOG committee opinion. Placenta accreta. Number 266, January 2002. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 2002. 77:77–78. PMid:12053897

9. Comstock CH. 2005. Antenatal diagnosis of placenta accreta: a review. Ultrasound Obstet Gynecol. 26:89–96. http://dx.doi.org/10.1002/uog.1926; PMid:15971281

10. Descargues G, Douvrin F, Degrй S, Lemoine JP, Marpeau L, Clavier E. 2001. Abnormal placentation and selective embolization of the uterine arteries. Eur J Obstet Gynecol Reprod Biol 99:47–52. http://dx.doi.org/10.1016/S0301-2115(01)00355-4

11. Doumouchtsis SK, Arulkumaran S. 2010. The morbidly adherent placenta: an overview of management options. Acta Obstet Gynecol Scand. 89:1126–33. http://dx.doi.org/10.3109/00016349.2010.503869; PMid:20804337

12. Flood KM, Said S, Geary M et al. 2009. Changing trends in peripartum hysterectomy over the last 4 decades. Am. J. Obstet. Gynecol. 200:632.el–632.e6.

13. Gielchinsky Y, Rojansky N, Fasouliotis SJ, Ezra Y. 2002. Placenta accreta: summary of 10 years: a survey of 310 cases. Placenta. 23:210–214. http://dx.doi.org/10.1053/plac.2001.0764; PMid:11945088

14. Kayem G, Davy C, Goffinet F et al. 2004. Conservative versus extirpative management in cases of placenta accrete. Obstet. and Gynecol. 104:531–536. http://dx.doi.org/10.1097/01.AOG.0000136086.78099.0f; PMid:15339764

15. Kent A. 2009. Management of placenta accrete. Rev. Obstet. Gynecol. 2;2:127–128.

16. Lam H, Pun TC, Lam PW. 2004. Successful conservative management of placenta previa accreta during caesarean section. Int. J. Gynecol. Obstet. 86:31–32. http://dx.doi.org/10.1016/j.ijgo.2003.12.009; PMid:15207668

17. Legro RS, Price FV, Hill LM, Caritis SN. 1994. Nonsurgical management of placenta percreta: a case report. Obstet Gynecol 83:847–849. PMid:8159372

18. Levine D, Hulka CA, Ludmir J, Li W, Edelman RR. 1997. Placenta accreta: evaluation with color Doppler US, power Doppler US, and MR imaging. Radiology 205:773–776. http://dx.doi.org/10.1148/radiology.205.3.9393534; PMid:9393534

19. Liao CHY, Ding DCH. 2009. Failure of conservative treatment for placenta increta. Taiwan J Obstet Gynecol. 48:302–304. http://dx.doi.org/10.1016/S1028-4559(09)60310-7

20. Miller DA, Chollet JA, Goodwin TM. 1997. Clinical risk factors for placenta previa-placenta accreta. Am J Obstet Gynecol. 177:210–214. http://dx.doi.org/10.1016/S0002-9378(97)70463-0

21. Mussalli GM, Shah J, Berck DJ et al. 2000. Placenta accreta and methotrexate therapy: three case reports. J. Perinatol. 20:331–334. http://dx.doi.org/10.1038/sj.jp.7200373; PMid:10920795

22. O‘Brien JM, Barton JR, Donaldson ES. 1996. The management of placenta percreta: conservative and operative strategies. Am J Obstet Gynecol. 175:1632–8. http://dx.doi.org/10.1016/S0002-9378(96)70117-5

23. Ophir E, Singer-Jordan J, Odeh M, Hirch Y, Maksimovsky O, Shaider O et al. 2009. Abnormal placental invasion – a novel approach to treatment. Obstet Gynecol Surv. 64:811–22. http://dx.doi.org/10.1097/OGX.0b013e3181c46913; PMid:19939295

24. Palacios Jaraquemada JM, Bruno CH. 2005. MRI in 300 cases of placenta accereta: surgical correlation of new findings. Acta Obstet. Gynecol. Scand. 84:719–727. http://dx.doi.org/10.1111/j.0001-6349.2005.00832.x; PMid:16026395

25. Palacios Jaraquemada JM, Pesaresi M, Nassif JC, Hermosid S. 2004. Anterior placenta percreta: surgical approach, hemostasis and uterine repair. Acta Obstet Gynecol Scand. 83(8):738–44. http://dx.doi.org/10.1080/j.0001-6349.2004.00517.x; http://dx.doi.org/10.1111/j.0001-6349.2004.00517.x; PMid:15255846

26. Palacios-Jaraquemada JM. 2008. Diagnosis and management of placenta accreta. Best Pract Res Clin Obstet Gynaecol. 22:1133–1148. http://dx.doi.org/10.1016/j.bpobgyn.2008.08.003; PMid:18815074

27. Sentilhes L, Ambroselli C, Kayem G, Provansal M, Fernandez H, Perrotin F et al. 2010. Maternal outcome after conservative treatment of placenta accreta. Obstet Gynecol. 115:526–34. http://dx.doi.org/10.1097/AOG.0b013e3181d066d4; PMid:20177283

28. Suh YH, Song EH, Kim DH, Lee YH, Park HY, Koh KS et al. 2003. A clinical study of placental adhesions: placenta accreta, placenta increta, and placenta percreta. Korean J Obstet Gynecol. 46:81–88.

29. Suner S, Jagminas L, Peipert JF, Linakis J. 1996. Fatal spontaneous rupture of a gravid uterus: Case report and literature review of uterine rupture. J Emerg Med. 14:181–185. http://dx.doi.org/10.1016/0736-4679(95)02091-8

30. Thia EWH, Tan L-K, Devendra K et al. 2007. Lessons learnt from two women with morbiditly adherent placentas and a review of literature. Ann. Acad. Med. Singapore. 36:298–303. PMid:17483862

31. Timmermans S, van Hof AC, Duvekot JJ. 2007. Conservative management of abnormally invasive placentation. Obstet. Gynecol. Surv. 62;8:529–539. http://dx.doi.org/10.1097/01.ogx.0000271133.27011.05; PMid:17634154

32. Tong SYP, Tay KH, Kwek YCK. 2008. Conservative management of placenta accreta: review of three cases. Singapore Med. J. 49;6:e156–e159. PMid:18581009

33. Warshak CR, Ramos GA, Eskander R, Benirschke K, Saenz CC, Kelly TF et al. 2010. Effect of predelivery diagnosis in 99 consecutive cases of placenta accreta. Obstet Gynecol. 115:65–9. http://dx.doi.org/10.1097/AOG.0b013e3181c4f12a; PMid:20027036

34. Yi KW, Oh M-J, Seo T-S et al. 2010. Prophylactic hypogastric artery ballooning in a patient with complete placenta previa and increta. J. Korean Med. Sci. 25:651–655. http://dx.doi.org/10.3346/jkms.2010.25.4.651; PMid:20358016 PMCid:PMC2844598