title: Lessons learnt from two women with morbidly adherent placentas and a review of literature.
abstract: BACKGROUND
  Pathologically adherent placentas occur when there is a defect of the decidua basalis, typically arising from previous caesarean section, resulting in abnormally invasive implantation of the placenta. The depth of placental invasion varies from the superficial (accreta), to transmural and possibly beyond (percreta).
  
  
  METHODS
  We report on 2 cases, one treated "conservatively", the other with a caesarean hysterectomy, both of which led to a safe outcome for both mother and baby.
  
  
  CONCLUSIONS
  Management relies on accurate early diagnosis with appropriate perioperative multidisciplinary planning to anticipate and avoid massive obstetric haemorrhage at delivery.
authors.affiliation: Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore. edwintwh@gmail.com
authors.forename: Edwin W H
authors.initials: EW
authors.lastname: Thia
authors.forename: Lay-Kok
authors.initials: LK
authors.lastname: Tan
authors.forename: Kanagalingam
authors.initials: K
authors.lastname: Devendra
authors.forename: Tze-Tein
authors.initials: TT
authors.lastname: Yong
authors.forename: Hak-Koon
authors.initials: HK
authors.lastname: Tan
authors.forename: Tew-Hong
authors.initials: TH
authors.lastname: Ho
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects* / Q000706:statistics & numerical data; D003656:Decidua / Q000002:abnormalities; D005260:Female; D006801:Humans; D007044:Hysterectomy; D015994:Incidence; D008279:Magnetic Resonance Imaging; D010920:Placenta / Q000002:abnormalities / Q000000981:diagnostic imaging; D010921:Placenta Accreta / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D011247:Pregnancy; D013785:Thailand / Q000453:epidemiology; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000209:etiology*