Clinical Analysis Of Placenta Accreta

Objective To discuss the clinical characters, diagnosis and treatment methods ofplacenta accreta.Methods Retrospective analysis was made in 47cases of placenta accreta from May1997 to May 2007 in Peking Union Medical College Hospital.These cases include 17cases in the second stage of pregnancy and 30 cases in the third trimester.Results During May 1997 to May 2007, the incidence of placenta accreta in ourhospital was 2.62‰.Most of these cases had received one or more dilatation andcurettage, previous cesarean delivery, or myomectomy. Some cases were found withplacenta previa or myoma in the current pregnancy. There were 61.70％of all thecases with hemorrhage. In the 17 cases in the second stage of pregnancy there are 12cases were diagnosed by B-ultrasound and 5 by clinical evidence.While in the 30cases in the third trimester there are 8 cases ware diagnosed by pathology,2 byB-ultrasound and 20 by clinical evidence.45 cases had been cured by conservativetreatment.These methods include dilatation and curettage, uterine arteryembolism(UAE) with or without MTX, package and B-lynch suture, singly withMTX, RU-486. Only 2 cases received cesarean hysterectomy.Conclusion The incidence of placenta accreta is rising.The incidence in the secondstage of pregnancy was higher than that in the third. No cases can be diagnosed byB-ultrasound before birth.In the second stage most cases can be diagnosed byB-ultrasound after labor, and now UAE is the best satisfactory conservativemanagement. While in the third trimester few cases can be diagnosed byB-ultrasound, and clinical evidence is the most frequent diagnostic methods, tampingis one of the best satisfactory conservative management. In our hospital a majority ofthe cases had been cured by conservative therapy which could in turn avoid hysterectomy.