title: Management of placenta accreta.
abstract: Cesarean hysterectomy is considered the reference standard treatment for placenta accreta. In young women who want the option of future pregnancy and agree to close follow-up monitoring, conservative treatment is a valid option. Several key points of both cesarean hysterectomy and conservative treatment remain debatable, such as timing of delivery, attempted removal of the placenta, use of temporal internal iliac occlusion balloon catheters, ureteral stents, prophylactic embolization, and methotrexate. In cases of placenta percreta with bladder involvement, conservative treatment may be the optimal management. Regardless of the chosen option, the woman and her partner should be warned of the high risk of maternal complications related to an abnormally invasive placenta.
authors.affiliation: Department of Obstetrics and Gynecology, Angers University Hospital, Angers, France.
authors.forename: Loïc
authors.initials: L
authors.lastname: Sentilhes
authors.forename: François
authors.initials: F
authors.lastname: Goffinet
authors.forename: Gilles
authors.initials: G
authors.lastname: Kayem
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use; D002585:Cesarean Section; D003131:Combined Modality Therapy; D005260:Female; D059247:Fertility Preservation; D006489:Hemostatic Techniques; D006801:Humans; D007044:Hysterectomy; D008727:Methotrexate / Q000627:therapeutic use; D010921:Placenta Accreta / Q000175:diagnosis / Q000628:therapy*; D011247:Pregnancy; D011296:Prenatal Diagnosis
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate
keywords: Abnormally invasive placenta; antenatal diagnosis; cesarean hysterectomy; conservative treatment; management; placenta accreta or percreta