Placenta accreta in the department of gynaecology and obstetrics in Rabat, Morocco: case series and review of the literature.
Abnormal placentation
accreta
caesarean hysterectomy
indicated preterm delivery
percreta
Journal
The Pan African medical journal
ISSN: 1937-8688
Titre abrégé: Pan Afr Med J
Pays: Uganda
ID NLM: 101517926
Informations de publication
Date de publication:
2019
2019
Historique:
received:
16
11
2018
accepted:
11
03
2019
entrez:
7
9
2019
pubmed:
7
9
2019
medline:
8
10
2019
Statut:
epublish
Résumé
Placenta accreta spectrum disorders is a rare pathology but the incidence has not stopped to increase in recent years. The purpose of our work was the analysis of the epidemiological profile of our patients, the circumstances of diagnosis, the interest of paraclinical explorations in antenatal diagnosis and the evaluation of the evolutionary profile. We hereby report a case series spread over a period of one year from 01/01/2015 to 01/01/2016 at the Gynaecology-Obstetrics department of the University Hospital Center IBN SINA of Rabat where we identified six cases of placenta accreta. We selected patients whose diagnosis was confirmed clinically and histologically. The major risk factors identified were a history of placenta previa, previous caesarean section, advanced maternal age, multiparity. 2D ultrasound and magnetic resonance imaging (MRI) allowed us to strongly suspect the presence of a placenta accreta in a pregnant woman with risk factor(s) but the diagnosis of certainty was always histological. Placenta accreta spectrum disorders were associated with a high risk of severe postpartum hemorrhage, serious comorbidities, and maternal death. Leaving the placenta in situ was an option for women who desire to preserve their fertility and agree to continuous long-term monitoring in centers with adequate expertise but a primary elective caesarean hysterectomy was the safest and most practical option. Placenta accreta spectrum disorders is an uncommon pathology that must be systematically sought in a parturient with risk factors, to avoid serious complications. In light of the latest International Federation of Gynecology and Obstetrics (FIGO) recommendations of 2018, a review of the literature and finally the experience of our center, we propose a course of action according to whether the diagnosis of the placenta is antenatal or perpartum.
Identifiants
pubmed: 31489064
doi: 10.11604/pamj.2019.33.86.17700
pii: PAMJ-33-86
pmc: PMC6711691
doi:
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
86Déclaration de conflit d'intérêts
The authors declare no competing interests.
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