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Korean Journal of Obstetrics & Gynecology 2003;46(1):81-88.
Published online January 1, 2003.
A Clinical Study of Placental Adhesions: Placenta Accreta, Placenta Increta, and Placenta Percreta.
Young Hoon Suh, Eun Ho Song, Dong Hee Kim, Yeon Hee Lee, Hye Young Park, Kyung Sim Koh, Choong Hak Park
1Department of Obstetrics and Gynecology, Dankook University College of Medicine, Cheonan, Korea.
2Department of Anesthesiology, Dankook University College of Medicine, Cheonan, Korea.
3Department of Radiology, Dankook University College of Medicine, Cheonan, Korea.
4Department of Obstetrics and Gynecology, Pundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea.
5Mai Obstetrcis and Gynecology Clinic, Goyang, Korea.
Abstract
OBJECTIVE
The objective of this study is to investigate the clinical characteristics of placental adhesions in order to improve maternal and fetal well-beings. METHODS: We reviewed the medical records of twenty cases of placental adhesions from January 1, 1995 to December 31, 1999 in Dankook University Medical Center. RESULTS: The incidence of placental adhesions is 0.267%. Of them, the percentage of placenta accreta was 35%, placenta increta, 60% and placenta percreta, 5%. Placental adhesions were observed more often in multipara (80%) than nullipara (20%). Co-existing placenta previa (50%), previous cesarean delivery (40%), multigravidity (5 or more; 40%) and previous artificial abortion (70%) were associated with placental adhesions. 85% of placental adhesions were treated by hysterectomy in order to manage postpartal uterine bleeding. Packed red cell transfusions were necessary in 18 cases of placental adhesions (90%). Maternal complications were wound infection (10%), disseminated intravascular coagulation, throm- boembolism, stress ulcer, postoperative fever, bladder perforation, pulmonary edema, and pleural effusion etc. Fetal complications were preterm birth (30%), neonatal death (5%), and fetal death in utero (10%). CONCLUSION: This study revealed that placental adhesions show grave maternal and fetal complications. Obstetricians should examine carefully to confirm placental adhesions and prepare thoroughly the postpartal emergency-care, especially in the high-risk gravida.
Key Words: Placental adhesions, Placenta accreta, Placenta increta, Placenta percreta


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