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The management and outcomes of placenta accreta, increta and percreta in the UK: a population-based descriptive study
- Placenta accreta/increta/percreta is thought to be becoming more common; however, there are limited data to guide evidence-based management.
- The aim of this study was to describe the management and outcomes of the condition in a national cohort.
- In total, 134 women with placenta accreta/increta/percreta were identified, in 50% of whom (66/133) the condition was suspected antenatally.
- Women identified antenatally had lower levels of haemorrhage (median blood loss 2750 ml versus 6100 ml, P = 0.008) and were less likely to receive a blood transfusion (59% versus 94%, P = 0.014) than women in whom the diagnosis was not suspected antenatally.
- Women diagnosed antenatally were more likely to receive preventive therapies for haemorrhage.
- Women in whom no attempt was made to remove the placenta, either prior to hysterectomy or prior to conservative management, had lower estimated blood loss (median 1750 ml versus 3700 ml, P = 0.001) and fewer received a blood transfusion (57% versus 86%, P < 0.001) than women in whom an attempt was made to remove the placenta.
- These findings support current RCOG and other guidelines which recommend that if the placenta fails to separate, no attempt is made to remove it prior to a planned attempt at uterine conservation or hysterectomy.
Thank you to all members who contributed information to this study.
Details of this and other UKOSS study results can be obtained from the UKOSS website http://www.npeu.ox.ac.uk/ukoss/completed-surveillance. If you would like a reprint of any UKOSS publications please contact email@example.com.