title: Outcomes of subsequent pregnancies after conservative treatment for placenta accreta.
abstract: OBJECTIVE
  To estimate the association between conservative treatment for placenta accreta and subsequent pregnancy outcomes.
  
  
  METHODS
  In a retrospective study, data were analyzed on women who received conservative treatment for placenta accreta (removal of the placenta with uterine preservation) at a tertiary hospital in Jerusalem, Israel, between 1990 and 2000. Data were collected on subsequent pregnancies and neonatal outcomes until 2010, and compared with those from a matched control group of women who did not have placenta accreta.
  
  
  RESULTS
  A total of 134 women were included in both groups. Placenta accreta occurred in 62 (22.8%) of 272 subsequent deliveries in the study group for which data were available and 5 (1.9%) of 266 in the control group (relative risk [RR] 12.13; 95% confidence interval [CI] 4.95-29.69; P<0.001). Early postpartum hemorrhage occurred in 23 (8.6%) of 268 deliveries in the study group and 7 (2.6%) of 268 in the control group (RR 3.29; 95% CI 1.43-7.53; P<0.001). The odds ratio for recurrent placenta accreta in subsequent deliveries in the study group was 15.41 (95% CI 6.09-39.03; P<0.001).
  
  
  CONCLUSIONS
  Although subsequent pregnancies after conservative treatment for placenta accreta were mostly successful, the risk of recurrent placenta accreta and postpartum hemorrhage is high in future deliveries.
authors: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. Electronic address: doronkabiri@gmail.com.
authors: Doron
authors: D
authors: Kabiri
authors: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors: Yael
authors: Y
authors: Hants
authors: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors: Neta
authors: N
authors: Shanwetter
authors: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors: Moshe
authors: M
authors: Simons
authors: Department of Anesthesiology and Critical Care Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors: Carolyn F
authors: CF
authors: Weiniger
authors: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors: Yuval
authors: Y
authors: Gielchinsky
authors: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors: Yossef
authors: Y
authors: Ezra
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D010921:Placenta Accreta / Q000601:surgery*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D055815:Young Adult
keywords: Adherent placenta; Conservative treatment; Placenta accreta; Postpartum hemorrhage