Risk of hemorrhage in abnormally invasive placenta according to its management

• Type: Another Publication in an International Scientific Journal
• Date: 2017

Authors

Pinto, PV (Author) FMUP; Machado, AP (Author) Other; Montenegro, N (Author) Other

Journal

Title: Journal of Maternal-Fetal and Neonatal Medicine

Vol. 30

Pages: 2139-2145

ISSN: 1476-7058

Publisher: Taylor & Francis

Indexing

ISI Web of Knowledge - 6 Citations

Other information

Authenticus ID: P-00R-B3B

DOI: 10.1080/14767058.2016.1240163

Abstract (EN): Severe hemorrhage is a major concern during operative procedures for abnormally invasive placenta (AIP). We reviewed published literature with the objective to provide evidence of blood loss with the most common treatment options for AIP. We selected 54 articles that fulfilled the inclusion criteria. Cesarean hysterectomy, with or without occlusion balloons in the internal iliac arteries, was the treatment associated with the greatest blood loss. Major blood loss was also associated with the placenta left in situ (reported in 3 of 10 articles), and with uterine artery embolization (reported in 3 of 15 articles). The best outcomes were seen for cesarean hysterectomy with balloon occlusion of the common iliac arteries (CIA; 9 patients, including 1 with major blood loss), balloon occlusion of the abdominal aorta (27 patients, no major blood loss) and conservative surgery (99 patients, including one with major blood loss). In conclusion, cesarean hysterectomy with balloon occlusion of the CIA or abdominal aorta, and conservative treatments seem to have the best outcomes. However, our results are based on a small number of articles. Hence, it is necessary to have available more reports on the outcomes of these treatments, to arrive at a more definitive conclusion.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7