Self-reported physical, mental, and reproductive sequelae after treatment of abnormally invasive placenta: a single-center observational study.
Abnormally invasive placenta
Accrete
Cesarean hysterectomy
Conservative management
Expectant management
Inreta
Percreta
Placenta
Journal
Archives of gynecology and obstetrics
ISSN: 1432-0711
Titre abrégé: Arch Gynecol Obstet
Pays: Germany
ID NLM: 8710213
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
received:
27
12
2018
accepted:
24
04
2019
pubmed:
10
5
2019
medline:
18
4
2020
entrez:
10
5
2019
Statut:
ppublish
Résumé
To analyze the types of treatment of abnormally invasive placenta (AIP) and to investigate the self-reported physical and mental short- and long-term sequelae. This single-center observational study was performed between 2003 and 2017. Women with prenatal or intrapartum diagnosis of AIP were identified through the departmental database. Classification was performed according to the time of diagnosis establishment and the type of treatment. Medical complications overall and according to the type of treatment were analyzed. Data about women's perception of diagnosis, treatment, and short- and long-term sequelae were gathered by questionnaire. Cases were classified into four groups: prenatal diagnosis, cesarean hysterectomy (A, n = 10); prenatal diagnosis, expectant management (B, n = 19); intrapartum diagnosis, cesarean hysterectomy (C, n = 6); intrapartum diagnosis, conservative therapy (D, n = 20). Depth of invasion, total units of transfused red blood cells, and the need for reoperation differed between the treatment groups. Expectant management was successful in 94.7% of cases. Irrespective of the treatment group, 73.3% of women perceived the condition as serious or life-threatening; 30.0% utilized psychological support; and 36.7% reported persistent pain or problems. 37.5% of women after uterine preservation had another live birth, AIP recurred in 44.4% of cases. Conservative management of AIP is feasible in selected cases. The condition is perceived as life-threatening and has a lasting impact on the physical, mental, and reproductive health of those affected. This finding merits further investigation. AIP continues to be a condition with high morbidity.
Identifiants
pubmed: 31069488
doi: 10.1007/s00404-019-05175-z
pii: 10.1007/s00404-019-05175-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM