title: Abnormally invasive placenta: changing trends in diagnosis and management.
abstract: Trends in patient profile, clinical presentation, diagnosis, management options and outcome of abnormally invasive placenta (AIP) were retrospectively evaluated at a tertiary care centre from 2001 to 2010. AIP was diagnosed when confirmed by ultrasound or MRI, when complete manual removal of placenta was not possible or when histological confirmation was achieved in a hysterectomy specimen. The first and second halves of the time period were compared. The total number of cases was 56 and the incidence increased significantly in the second half. Main risk factors were placenta previa and previous cesarean section. Antenatal diagnosis by ultrasound was made in 72% in the second half, compared with 35% in the first half (p = 0.009). Maternal mortality was 29% in the first half and 21% in the second half. Hysterectomy was the mainstay in management; elective procedures being significantly higher in the second half.
authors.affiliation: Department of Obstetrics and Gynecology, University College of Medical Science and Guru Teg Bahadur Hospital, Delhi, India.
authors.forename: Kiran
authors.initials: K
authors.lastname: Guleria
authors.forename: Bindiya
authors.initials: B
authors.lastname: Gupta
authors.forename: Shuchi
authors.initials: S
authors.lastname: Agarwal
authors.forename: Amita
authors.initials: A
authors.lastname: Suneja
authors.forename: Neelam
authors.initials: N
authors.lastname: Vaid
authors.forename: Sandhya
authors.initials: S
authors.lastname: Jain
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D015994:Incidence; D007194:India / Q000453:epidemiology; D010920:Placenta / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology*; D010921:Placenta Accreta / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D010923:Placenta Previa / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D006473:Postpartum Hemorrhage / Q000517:prevention & control; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D014463:Ultrasonography; D016387:Women's Health; D055815:Young Adult