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Table 2 Management Strategies for Patients with Placenta Percreta

From: Multidisciplinary approach to manage antenatally suspected placenta percreta: updated algorithm and patient outcomes

  Cesarean Hysterectomy
N = 7
n (%)
Delayed Hysterectomy
N = 13
n (%)
Reason to proceed to Cesarean Hysterectomy
 Placental separation occurred at time of delivery 1 (14) N/A
 No extra-uterine involvement 3 (43) N/A
 Patient preference 2 (29) N/A
 Second trimester 1 (14) N/A
Anesthetic Technique at time of delivery
 General 3 (43) 5 (38)
 Neuraxial 1 (14) 7 (54)
 Neuraxial followed by general 3 (43) 1 (8)
Non-operative blood loss strategies
 Tranexamic acid (1 g) 2 (29) 1 (8)
 Cell saver 2 (29) 0
Urologic Procedures
 Cystoscopy only 0 1 (8)
 Ureteral stents 1 (14) 5 (38)
 Intentional cystotomy 1 (14) 2 (15)
Interventional radiology procedures
 Prophylactic occlusion balloons only 3 (43) 0
 Prophylactic occlusion balloon +embolization 1 (14) 7 (54)
 Prophylactic embolization 2 (29) 5 (38)
 Femoral access only 1 (14) 0
Prophylactic antibiotic after delivery for placenta left in situ N/A 2 (15)
Methotrexate administration N/A 3 (23)
 Median number of cycles [range]   4 [4–5]
Interval of time (days) between delivery to hysterectomy N/A 41 [26–68]
Surgical approach N/A  
 Modified radical   6 (46)
 Total abdominal   4 (31)
 Laparoscopic   3 (23)