The management and outcomes of placenta accreta, increta, and percreta in the UK: a population-based descriptive study

Research output: Contribution to journalArticlepeer-review

Standard

The management and outcomes of placenta accreta, increta, and percreta in the UK : a population-based descriptive study. / Fitzpatrick, K E; Sellers, S; Spark, P; Kurinczuk, J J; Brocklehurst, Peter; Knight, M.

In: BJOG: An International Journal of Obstetrics & Gynaecology, Vol. 121, No. 1, 01.2014, p. 62-70; discussion 70-1.

Research output: Contribution to journalArticlepeer-review

Harvard

APA

Vancouver

Author

Bibtex

@article{155a0614249a4f78af32a116c0d2e7ec,
title = "The management and outcomes of placenta accreta, increta, and percreta in the UK: a population-based descriptive study",
abstract = "OBJECTIVE: To describe the management and outcomes of placenta accreta, increta, and percreta in the UK.DESIGN: A population-based descriptive study using the UK Obstetric Surveillance System (UKOSS).SETTING: All 221 UK hospitals with obstetrician-led maternity units.POPULATION: All women diagnosed with placenta accreta, increta, and percreta in the UK between May 2010 and April 2011.METHODS: Prospective case identification through the monthly mailing of UKOSS.MAIN OUTCOME MEASURES: Median estimated blood loss, transfusion requirements.RESULTS: A cohort of 134 women were identified with placenta accreta, increta, or percreta: 50% (66/133) were suspected to have this condition antenatally. In women with a final diagnosis of placenta increta or percreta, antenatal diagnosis was associated with reduced levels of haemorrhage (median estimated blood loss 2750 versus 6100 ml, P = 0.008) and a reduced need for blood transfusion (59 versus 94%, P = 0.014), possibly because antenatally diagnosed women were more likely to have preventative therapies for haemorrhage (74 versus 52%, P = 0.007), and were less likely to have an attempt made to remove their placenta (59 versus 93%, P < 0.001). Making no attempt to remove any of the placenta, in an attempt to conserve the uterus or prior to hysterectomy, was associated with reduced levels of haemorrhage (median estimated blood loss 1750 versus 3700 ml, P = 0.001) and a reduced need for blood transfusion (57 versus 86%, P < 0.001).CONCLUSIONS: Women with placenta accreta, increta, or percreta who have no attempt to remove any of their placenta, with the aim of conserving their uterus, or prior to hysterectomy, have reduced levels of haemorrhage and a reduced need for blood transfusion, supporting the recommendation of this practice.",
keywords = "Blood Transfusion, Cesarean Section, Cohort Studies, Dinoprost, Ergonovine, Female, Great Britain, Humans, Hysterectomy, Misoprostol, Oxytocics, Oxytocin, Placenta Accreta, Postpartum Hemorrhage, Pregnancy, Prospective Studies, Treatment Outcome, Uterine Artery Embolization, Journal Article, Observational Study, Research Support, Non-U.S. Gov't",
author = "Fitzpatrick, {K E} and S Sellers and P Spark and Kurinczuk, {J J} and Peter Brocklehurst and M Knight",
note = "{\textcopyright} 2013 RCOG.",
year = "2014",
month = jan,
doi = "10.1111/1471-0528.12405",
language = "English",
volume = "121",
pages = "62--70; discussion 70--1",
journal = "BJOG: An International Journal of Obstetrics & Gynaecology",
issn = "1470-0328",
publisher = "Wiley",
number = "1",

}

RIS

TY - JOUR

T1 - The management and outcomes of placenta accreta, increta, and percreta in the UK

T2 - a population-based descriptive study

AU - Fitzpatrick, K E

AU - Sellers, S

AU - Spark, P

AU - Kurinczuk, J J

AU - Brocklehurst, Peter

AU - Knight, M

N1 - © 2013 RCOG.

PY - 2014/1

Y1 - 2014/1

N2 - OBJECTIVE: To describe the management and outcomes of placenta accreta, increta, and percreta in the UK.DESIGN: A population-based descriptive study using the UK Obstetric Surveillance System (UKOSS).SETTING: All 221 UK hospitals with obstetrician-led maternity units.POPULATION: All women diagnosed with placenta accreta, increta, and percreta in the UK between May 2010 and April 2011.METHODS: Prospective case identification through the monthly mailing of UKOSS.MAIN OUTCOME MEASURES: Median estimated blood loss, transfusion requirements.RESULTS: A cohort of 134 women were identified with placenta accreta, increta, or percreta: 50% (66/133) were suspected to have this condition antenatally. In women with a final diagnosis of placenta increta or percreta, antenatal diagnosis was associated with reduced levels of haemorrhage (median estimated blood loss 2750 versus 6100 ml, P = 0.008) and a reduced need for blood transfusion (59 versus 94%, P = 0.014), possibly because antenatally diagnosed women were more likely to have preventative therapies for haemorrhage (74 versus 52%, P = 0.007), and were less likely to have an attempt made to remove their placenta (59 versus 93%, P < 0.001). Making no attempt to remove any of the placenta, in an attempt to conserve the uterus or prior to hysterectomy, was associated with reduced levels of haemorrhage (median estimated blood loss 1750 versus 3700 ml, P = 0.001) and a reduced need for blood transfusion (57 versus 86%, P < 0.001).CONCLUSIONS: Women with placenta accreta, increta, or percreta who have no attempt to remove any of their placenta, with the aim of conserving their uterus, or prior to hysterectomy, have reduced levels of haemorrhage and a reduced need for blood transfusion, supporting the recommendation of this practice.

AB - OBJECTIVE: To describe the management and outcomes of placenta accreta, increta, and percreta in the UK.DESIGN: A population-based descriptive study using the UK Obstetric Surveillance System (UKOSS).SETTING: All 221 UK hospitals with obstetrician-led maternity units.POPULATION: All women diagnosed with placenta accreta, increta, and percreta in the UK between May 2010 and April 2011.METHODS: Prospective case identification through the monthly mailing of UKOSS.MAIN OUTCOME MEASURES: Median estimated blood loss, transfusion requirements.RESULTS: A cohort of 134 women were identified with placenta accreta, increta, or percreta: 50% (66/133) were suspected to have this condition antenatally. In women with a final diagnosis of placenta increta or percreta, antenatal diagnosis was associated with reduced levels of haemorrhage (median estimated blood loss 2750 versus 6100 ml, P = 0.008) and a reduced need for blood transfusion (59 versus 94%, P = 0.014), possibly because antenatally diagnosed women were more likely to have preventative therapies for haemorrhage (74 versus 52%, P = 0.007), and were less likely to have an attempt made to remove their placenta (59 versus 93%, P < 0.001). Making no attempt to remove any of the placenta, in an attempt to conserve the uterus or prior to hysterectomy, was associated with reduced levels of haemorrhage (median estimated blood loss 1750 versus 3700 ml, P = 0.001) and a reduced need for blood transfusion (57 versus 86%, P < 0.001).CONCLUSIONS: Women with placenta accreta, increta, or percreta who have no attempt to remove any of their placenta, with the aim of conserving their uterus, or prior to hysterectomy, have reduced levels of haemorrhage and a reduced need for blood transfusion, supporting the recommendation of this practice.

KW - Blood Transfusion

KW - Cesarean Section

KW - Cohort Studies

KW - Dinoprost

KW - Ergonovine

KW - Female

KW - Great Britain

KW - Humans

KW - Hysterectomy

KW - Misoprostol

KW - Oxytocics

KW - Oxytocin

KW - Placenta Accreta

KW - Postpartum Hemorrhage

KW - Pregnancy

KW - Prospective Studies

KW - Treatment Outcome

KW - Uterine Artery Embolization

KW - Journal Article

KW - Observational Study

KW - Research Support, Non-U.S. Gov't

U2 - 10.1111/1471-0528.12405

DO - 10.1111/1471-0528.12405

M3 - Article

C2 - 23924326

VL - 121

SP - 62-70; discussion 70-1

JO - BJOG: An International Journal of Obstetrics & Gynaecology

JF - BJOG: An International Journal of Obstetrics & Gynaecology

SN - 1470-0328

IS - 1

ER -