title: Placenta accreta as a cause of peripartum hysterectomy.
abstract: BACKGROUND
  Our objective was to identify the risk factors associated with placenta accreta.
  
  
  METHODS
  Cases of peripartum hysterectomy at University Hospital of Bratislava were identified in the period from January 1st 2008 to December 31th 2013. Included were only those cases which had a histological evidence of placenta accreta.
  
  
  RESULTS
  Fifty patients, who underwent peripartum hysterectomy were included in the study. Between 2008 and 2013 eight cases of placenta accreta were identified. Five (62.5 %) of these were suspected before delivery. The overall incidence of PA was 0.19 per 1000 deliveries. Median gestational age at delivery was 37 weeks (range 25-41 weeks). Six of eight (75 %) women with placenta accreta had a previous caesarean delivery or curettage. In 5 patients both placenta praevia and prior Caesarean delivery were present. Among the 50 women who underwent peripartum hysterectomy, 8 (16 %) were patients with both prenatally diagnosed placenta praevia and previous caesarean delivery, placenta accreta was suspected in 4 of these (50 %) compared with 10 of 42 (24 %) without this combination of risk factors.
  
  
  CONCLUSIONS
  Those in whom placenta accreta was suspected were delivered earlier than 37 weeks of gestation and were less likely to have emergency delivery. Placenta accreta is the second most common indication for an emergency peripartum hysterectomy. There is a high suspicion of placenta accreta in patients with placenta praevia and after previous Caesarean section (Tab. 3, Ref. 17).
authors.forename: E
authors.initials: E
authors.lastname: Palova
authors.forename: M
authors.initials: M
authors.lastname: Redecha
authors.forename: A
authors.initials: A
authors.lastname: Malova
authors.forename: L
authors.initials: L
authors.lastname: Hammerova
authors.forename: Z
authors.initials: Z
authors.lastname: Kosibova
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects / Q000706:statistics & numerical data; D004630:Emergencies; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007044:Hysterectomy / Q000379:methods / Q000706:statistics & numerical data; D015994:Incidence; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D058725:Peripartum Period; D010921:Placenta Accreta / Q000473:pathology / Q000601:surgery; D010923:Placenta Previa / Q000175:diagnosis / Q000601:surgery; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000517:prevention & control; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D018154:Slovakia
keywords: Caesarean section.; peripartum hysterectomy; placenta accreta