Management
Women with placenta accreta are usually delivered by a cesarean section. It is better to perform the surgery under elective, controlled conditions rather than as an emergency
without adequate preparation. In addition, regardless of the management option made, prevention of complications ideally requires a multidisciplinary team approach [9]. The multidisciplinary team should include a gynecologic surgeon experienced in pelvic surgery, a blood bank team prepared to administer multiple blood components, experi- enced anesthesiology personnel who are skilled in obstetric anesthesia, skilled urologists in case a bladder resection or repair might be required, experienced intensivists for postpartum care, and an experienced neonatologist. In cases where pelvic artery catheterizations are used, an experienced interventional radiologist is also required. Additionally, Eller et al. showed that delivery at a medical center with a multidisciplinary care team resulted in a more than 50% risk reduction for composite early morbidity among all cases of placenta accreta and a nearly 80% risk reduction among those cases wherein accreta was suspected before delivery.
ManagementWomen with placenta accreta are usually delivered by a cesarean section. It is better to perform the surgery under elective, controlled conditions rather than as an emergencywithout adequate preparation. In addition, regardless of the management option made, prevention of complications ideally requires a multidisciplinary team approach [9]. The multidisciplinary team should include a gynecologic surgeon experienced in pelvic surgery, a blood bank team prepared to administer multiple blood components, experi- enced anesthesiology personnel who are skilled in obstetric anesthesia, skilled urologists in case a bladder resection or repair might be required, experienced intensivists for postpartum care, and an experienced neonatologist. In cases where pelvic artery catheterizations are used, an experienced interventional radiologist is also required. Additionally, Eller et al. showed that delivery at a medical center with a multidisciplinary care team resulted in a more than 50% risk reduction for composite early morbidity among all cases of placenta accreta and a nearly 80% risk reduction among those cases wherein accreta was suspected before delivery.
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