First-trimester abortion complicated with placenta accreta: A systematic review
Autor: | Shih-Shien Weng, Yeou-Lih Wang, Wen-Chu Huang |
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Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
Placenta accreta medicine.medical_treatment Placenta Accreta Abortion Hysterectomy lcsh:Gynecology and obstetrics Ultrasonography Prenatal 03 medical and health sciences 0302 clinical medicine Uterine artery embolization Pregnancy Risk Factors Retained placenta medicine Humans First trimester abortion Vaginal bleeding Postoperative Period Hysterotomy Abortion Therapeutic Transcatheter arterial chemoembolization lcsh:RG1-991 030219 obstetrics & reproductive medicine business.industry Obstetrics Obstetrics and Gynecology medicine.disease Pregnancy Trimester First Female Uterine Hemorrhage medicine.symptom business |
Zdroj: | Taiwanese Journal of Obstetrics & Gynecology, Vol 58, Iss 1, Pp 10-14 (2019) |
ISSN: | 1028-4559 |
Popis: | Placenta accreta is a potentially life-threatening condition that may complicate a first-trimester abortion in rare occasions, and it can be difficult to recognize. We reviewed the literature in PubMed-indexed English journals through August 2018 for first-trimester postabortal placenta accreta, after which 19 articles and 23 case reports were included. The risk factors for the development of abnormal placentation are previous cesarean section (87%), previous history of uterine curettage (43.5%), and previous history of surgical evacuation of a retained placenta (4.3%). Ten patients (43.5%) had an advanced age (≧35 years). Most patients clinically presented with vaginal bleeding, ranging from intermittent or irregular bleeding, persistent bleeding, and profuse or massive bleeding. The onset of symptoms might be during the intra- or immediate postoperative period. Some patients had delayed symptoms 1 week to 2 years postoperatively. Conservative management may be attempted as the primary rescue, including uterine artery embolization (UAE), transcatheter arterial chemoembolization (TACE) with dactinomycin, and laparoscopic hysterotomy with placental tissue removal. However, most reports in the literature suggested either abdominal or laparoscopic hysterectomy as the definitive treatment for first-trimester postabortal placenta accreta. High index of clinical suspicion with anticipation of placenta accreta in early pregnancy is highly essential for timely diagnosis, providing the physician better opportunities to promptly manage this emergent condition and improve outcomes. Keywords: First-trimester abortion, First-trimester pregnancy, Placenta accreta |
Databáze: | OpenAIRE |
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