Morbidity associated with nonemergent hysterectomy for placenta accreta.
OBJECTIVE
The purpose of this study was to report the morbidity of nonemergent hysterectomy for suspected placenta accreta.


METHODS
This was a retrospective study of all patients who underwent nonemergent hysterectomy for placenta accreta at Tampa General Hospital from June 1, 2003 to May 31, 2009.


RESULTS
Twenty-nine patients were identified. Diagnosis was suspected on ultrasound scanning in 26 women (6 women also underwent magnetic resonance imaging) and on direct vision at repeat cesarean section delivery in 3 women. All of the women were multiparous, and 18 women had undergone > or =2 cesarean section deliveries. Twenty-one women had a placenta previa, and 8 women had a low anterior placenta. Final pathologic findings revealed accreta (20 specimens), increta (6 women), and percreta (3 women). Mean total operative time was 216 minutes; blood loss was 4061 mL. Two women had ureteral transection (1 was bilateral); 3 women had cystotomy, and 3 women had partial cystectomy. Postoperative hemorrhage occurred in 5 women; 1 hemorrhage resolved after catheter embolization, and the other 4 hemorrhage required reoperation.


CONCLUSIONS
Nonemergent hysterectomy for placenta accreta is associated with significant morbidity in the forms of hemorrhage and urinary tract insult.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida School of Medicine, Tampa, FL, USA.
Mitchel S
MS
Hoffman
Rachel A
RA
Karlnoski
Devanand
D
Mangar
Valerie E
VE
Whiteman
Bruce R
BR
Zweibel
Jorge L
JL
Lockhart
Enrico M
EM
Camporesi
D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D010921:Placenta Accreta / Q000000981:diagnostic imaging / Q000601:surgery*; D011247:Pregnancy; D012189:Retrospective Studies; D014463:Ultrasonography; D014513:Ureter / Q000293:injuries*; D001743:Urinary Bladder / Q000293:injuries*