Table 2 Management Strategies for Patients with Placenta Percreta
| Â | Cesarean Hysterectomy NÂ =Â 7 n (%) | Delayed Hysterectomy NÂ =Â 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 | Â |
 Modified radical |  | 6 (46) |
 Total abdominal |  | 4 (31) |
 Laparoscopic |  | 3 (23) |