ABSTRACT

The method of uterus conserving when placenta accreta is discovered as the placenta is being removed during cesarean.

Retrospective study of the patients who were diagnosed with placenta accreta during cesarean section and managed with uterus conserving methods such as hemostatic sutures, balloon tamponade and when these techniques failed, the addition of internal iliac artery ligation (IIAL).

18 placenta accreta cases were managed with uterus conserving methods after the placenta was removed. Uteri of 10 women were conserved (55.5%). Eight of the 18 patients (44.4%) were initially managed with hemostatic sutures (55.5%) whereas 10 of them were initially managed with balloon tamponade. While success rates of balloon tamponade and hemostatic sutures were low when they were used by themselves (12.5%) adding IIAL techniques to these increased the rates of success to 50% and 62.5% respectively. No difference was observed between the women who managed with hemostatic sutures and balloon tamponade alone and the ones which were treated with hemostatic sutures, balloon tamponade and IIAL (p<0.005).

Uterus conserving methods such as hemostatic sutures or adding IIAL to the balloon tamponade may be tried in selected cases however it should be noted that half of these phenomena might still require hysterectomy.