title: Systematic review of uterus-preserving treatment modalities for abnormally invasive placenta.
abstract: This is a systematic review for evaluating failure rates (secondary hysterectomy or maternal mortality) and success rates (subsequent menstruation or pregnancy) following radiological or conservative surgical interventions for abnormally invasive placenta (AIP). Twelve cohort studies and 8 case series or case reports were included. The cumulative outcomes showed success rates of 159/177 (89.8) for arterial embolisation, a secondary hysterectomy in 20/177 (11.3%), a subsequent menstruation in 74/85 (87.1%) and a subsequent pregnancy in 3/10 (30%). Artery occlusion balloon presented a success rate of 33/42 (78.6%), and a secondary hysterectomy presented that of 8/42 (19%). Uterus-preserving surgery showed a success rate of 48/76 (63.2), a secondary hysterectomy in 23/76 (30%), maternal mortality in 2/54 (3.7%), a subsequent menstruation in 20/37 (81.1%) and a subsequent pregnancy in 21/27 (77.8%). This review indicates that different uterine-sparing radiological and surgical techniques may be effective in managing AIP in select patients.
authors.affiliation: a Department of Obstetrics and Gynecology , Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital , Chengdu , P. R. China.
authors.forename: J
authors.initials: J
authors.lastname: Mei
authors.affiliation: a Department of Obstetrics and Gynecology , Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital , Chengdu , P. R. China.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.affiliation: a Department of Obstetrics and Gynecology , Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital , Chengdu , P. R. China.
authors.forename: B
authors.initials: B
authors.lastname: Zou
authors.affiliation: a Department of Obstetrics and Gynecology , Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital , Chengdu , P. R. China.
authors.forename: Y
authors.initials: Y
authors.lastname: Hou
authors.affiliation: a Department of Obstetrics and Gynecology , Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital , Chengdu , P. R. China.
authors.forename: T
authors.initials: T
authors.lastname: Ma
authors.affiliation: a Department of Obstetrics and Gynecology , Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital , Chengdu , P. R. China.
authors.forename: M
authors.initials: M
authors.lastname: Chen
authors.affiliation: a Department of Obstetrics and Gynecology , Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital , Chengdu , P. R. China.
authors.forename: L
authors.initials: L
authors.lastname: Xie
mesh_terms: D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D059351:Organ Sparing Treatments; D010921:Placenta Accreta / Q000628:therapy*; D011247:Pregnancy; D013536:Suture Techniques; D058738:Uterine Balloon Tamponade
keywords: Abnormally invasive placenta; artery embolization; conservative management; systematic review; uterus-preserving therapy