« Previous Next » American Journal of Obstetrics & Gynecology
Volume 202, Issue 1 , Pages 38.e1-38.e9 , January 2010

Surgical management of placenta accreta: a cohort series and suggested approach

Presented at the combined XXIst Asian and Oceanic Congress of Obstetrics and Gynecology and Annual Scientific Meeting of the Royal Australian and New Zealand College of Obstetricians and Gynecologists, Auckland, New Zealand, March 27-30, 2009.

Tobias Angstmann, MB BS
- Division of Women's, Children's, and Family Health, Royal North Shore Hospital, St. Leonards, NSW, Australia
Gregory Gard, MB BS, BSc (Med)
- Division of Women's, Children's, and Family Health, Royal North Shore Hospital, St. Leonards, NSW, Australia
- Northern Clinical School, University of Sydney, Sydney, NSW, Australia
Tim Harrington, MB BS
- Department of Interventional Radiology, Royal North Shore Hospital, St. Leonards, NSW, Australia
Elizabeth Ward, MD
- Department of Anesthesia, Royal North Shore Hospital, St. Leonards, NSW, Australia
- Northern Clinical School, University of Sydney, Sydney, NSW, Australia
Amanda Thomson, MB BS
- Department of Hematology, Royal North Shore Hospital, St. Leonards, NSW, Australia
Warwick Giles, MB BS, PhD, CMFM
- Division of Women's, Children's, and Family Health, Royal North Shore Hospital, St. Leonards, NSW, Australia
- Northern Clinical School, University of Sydney, Sydney, NSW, Australia

Received 25 March 2009 ,Revised 15 June 2009 ,Accepted 20 August 2009.

The staged delivery algorithm
The asterisk indicates that the manufacturer is Codman & Shurtleff, Inc, Raynham, MA.;
IDC, indwelling catheter (bladder); PVA, polyvinyl alcohol.
Angstmann. Surgical managem

The staged delivery algorithm
The asterisk indicates that the manufacturer is Codman & Shurtleff, Inc, Raynham, MA.
IDC, indwelling catheter (bladder); PVA, polyvinyl alcohol.
Angstmann. Surgical management of placenta accreta. Am J Obstet Gynecol 2010.
- Full-Size Image
- Download to PowerPoint
Uterus in situ after embolization before hysterectomy and hysterectomy specimenA, View of the uterus in situ after embolization before hysterectomy (case 6) shows the abdominal incision held open with

Uterus in situ after embolization before hysterectomy and hysterectomy specimen
A, View of the uterus in situ after embolization before hysterectomy (case 6) shows the abdominal incision held open with the Bookwalter retractor (Codman & Shurtleff, Inc, Raynham, MA); B, the hysterectomy specimen shows the large dilated vascular collections that are typical of a placenta percreta in the lower uterine segment. The suture line from the classic cesarean section delivery can be seen in the upper uterine segment.
Angstmann. Surgical management of placenta accreta. Am J Obstet Gynecol 2010.
- Full-Size Image
- Download to PowerPoint
Angiographic studies show before and after uterine embolization through the left iliac arteryA, Angiography through the left iliac artery before embolization; B, angiography after embolization shows t

Angiographic studies show before and after uterine embolization through the left iliac artery
A, Angiography through the left iliac artery before embolization; B, angiography after embolization shows the marked decrease in placental vascularity.
Angstmann. Surgical management of placenta accreta. Am J Obstet Gynecol 2010.
- Full-Size Image
- Download to PowerPoint

Reprints not available from the authors.

Authorship and contribution to the article are limited to the 6 authors indicated. There was no outside funding or technical assistance with the production of this article.

Cite this article as: Angstmann T, Gard G, Harrington T, et al. Surgical management of placenta accreta: a cohort series and suggested approach. Am J Obstet Gynecol 2010;202:38.e1-9.

PII: S0002-9378(09)00963-6

doi: 10.1016/j.ajog.2009.08.037

« Previous Next » American Journal of Obstetrics & Gynecology
Volume 202, Issue 1 , Pages 38.e1-38.e9 , January 2010