Urologic considerations of placenta accreta: A contemporary tertiary care institutional experience

Solomon L. Woldu, Maria A. Ordonez, Patricia C. Devine, Jason D. Wright

Research output: Contribution to journalReview article

5 Scopus citations

Abstract

Background: As the incidence of cesarean delivery has increased, we are experiencing a higher incidence of subsequent placenta accreta and the associated complications, including urologic complications. Methods: This is a retrospective review of all patients delivered from 2000 to 2011 with a histologically proven diagnosis of placenta accreta. Data were analyzed for baseline maternal characteristics, intraoperative and postoperative outcomes and complications. Results: 83 patients were included in the analysis. The depth of placenta accreta invasion varied in the cohort, with 48, 25 and 27% being classified as placenta accreta, placenta increta and placenta percreta, respectively. 88% of patients had had a previous cesarean delivery, and 58% had more than one prior operative delivery. Cystotomy was encountered in 27% of patients and ureteral injury occurred in 4%. Degree of placenta accreta invasion, number of prior cesarean deliveries and intraoperative blood loss were associated with a higher likelihood of urologic injury. Conclusions: Urologic injuries are among the most frequently encountered intraoperative complications of placenta accreta. Surgeons involved in these cases need to be aware of this risk and maintain a high level of surveillance intraoperatively.

Original languageEnglish (US)
Pages (from-to)74-79
Number of pages6
JournalUrologia Internationalis
Volume93
Issue number1
DOIs
StatePublished - Jul 2014

Keywords

  • Female
  • Obstetrics
  • Placenta accreta
  • Trauma
  • Urogynecology

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