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Re: Placenta AccretaFrom: Gregory Lang (ovadoc@pris.bc.ca)Thu Jun 8 10:37:53 2000
I had an experience with two patients, one of mine and one in the hospital that I was working , with placenta previa accreta with bladder involvement. Both bleed during the pregnancy so both had an ultrasound. This was about 10 years ago as well. U/S suggested no placental plate and lakes of blood in the myometrium. Very good MFM guys did not diagnosis bladder involvement. Patient had a massive hemorrhage at C/S ( elective repeat) and had a hysterectomy. Did well but was not prepared with extra lines et cetera Second case, similar presentation. MRI confirmed accreta. Had elective hysterectomy with trauma team in the OR. Patient did quite well. U/S is first line of investigation. I scan all patients ( standard of care in Canada) to see where the placenta is.If they have a low lying anterior placenta in the face of a previous C/S I would get a MRI. Once burnt twice wise. Greg Le Toubib
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