Managements of placenta accreta.

From January 1986 to June 1990 at Veterans General Hospital-Taipei, 12 cases of placenta accreta were reviewed. The incidence were 1 per 1,101 deliveries. Eight cases were confirmed by pathological examination, and the incidence was 0.06% (1/1,652). Placenta previa was found in 7 cases (58.3%); 6 of them had history of cesarean section. All the cases had history of uterine surgery. Seven cases underwent cesarean section, and the other one received myomectomy. Hysterectomy was performed on 6 patients, and conservative treatments were employed on the other 6 cases. No maternal mortality occurred. Besides one case of missed abortion, there was only one perinatal loss due to immaturity. Accurate prenatal diagnosis of placenta accreta by ultrasound was obtained in 4 cases. Although hysterectomy is the definite treatment of placenta accreta, conservative managements should be tried before this intervention.