Coexistence of placenta praevia and accreta: A dangerous complication of pregnancy with an increasing frequency

Xiromeritis P1, Kalogiannidis I2, Papanikolaou A3

1Obstetrics and Gynecology clinic, Catholic University of Louvain, Brussels, Belgium
2Gynecologic Oncology clinic, Catholic University of Leuven, Belgium
31st Department of Obstetrics and Gynecology, Aristoteleio University of Thessaloniki, Thessaloniki, Greece

Correspondence: Xiromeritis Panayotis, 27 Kabouridou St, GR-55236, Thessaloniki, Greece. E-mail: panos.xiromeritis@tiscali.be


Abstract

Advanced maternal age and the increasing number of cesarean sections have led to a higher frequency of placenta praevia and/or accreta. Antenatal screening of these pregnancies, using the maternal medical history and the second trimester anatomy ultrasound scan, is necessary. Placenta praevia and/or accreta are responsible for a number of serious feto-maternal complications. Placenta praevia is a risk factor for IUGR, preterm delivery and retroplacental hematoma. Post-partum hemorrhage is the principal maternal complication. High risk pregnancies of placenta praevia should have a close follow-up. Cesarean section is preferred when the distance between the placenta and the internal cervical os is less than 2 cm. In cases of post-partum hemorrhage, conservative management seems to be effective. An experienced multidisciplinary medical team is needed during the conservative or surgical management.

Keywords: placenta praevia, placenta accreta, conservative management, post-partum hemorrhage

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