{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:12:13Z","timestamp":1790845933854,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,1,24]],"date-time":"2013-01-24T00:00:00Z","timestamp":1358985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine maternal morbidity in primary surgical management of placenta accreta.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Quaternary perinatal referral center in Melbourne, Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Clinically suspected and histologically confirmed cases of placenta accreta, increta and percreta.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women were identified from our hospital database coded for placenta accreta, increta, percreta and peripartum hysterectomy. Relevant details were sought from medical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Predefined maternal morbidities: blood loss, transfusion requirements, surgical complications, reoperation rate, duration in hospital. Predefined neonatal outcomes: gestational age at birth, birth\u2010weight, admission to intensive (<jats:styled-content style=\"fixed-case\">NICU<\/jats:styled-content>) or special care nurseries (<jats:styled-content style=\"fixed-case\">SCN<\/jats:styled-content>), respiratory distress syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between 1999 and 2009, 33 women were diagnosised with invasive placentation. A total of 27 were confirmed histologically after hysterectomy: 12 accreta, one increta, and 14 percreta. Median blood loss was 2\u00a0L. There was a 1.8\u2010L reduction in mean blood loss with elective vs. emergency hysterectomy (<jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.04). Nearly two\u2010thirds of women required four or more units of packed red\u2010blood\u2010cells. Half of the women suffered from surgical complications, mostly from bladder injury. The risk of returning to theater for further surgery was 20%. Women with placenta percreta were more likely to require additional blood products (<jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.03), sustain renal tract injury (<jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.003) and require intensive care admission (<jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A primary surgical approach to management of placenta accreta is associated with significant maternal morbidity, even when managed in a dedicated quaternary perinatal referral center.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12075","type":"journal-article","created":{"date-parts":[[2013,1,11]],"date-time":"2013-01-11T13:34:12Z","timestamp":1357911252000},"page":"445-450","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["Surgical management of placenta accreta: a 10\u2010year experience"],"prefix":"10.1111","volume":"92","author":[{"given":"SE Grace","family":"Tan","sequence":"first","affiliation":[{"name":"Maternal Fetal Medicine Unit Monash Medical Centre Southern Health Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas W","family":"Jobling","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology Monash Medical Centre Southern Health Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Euan M","family":"Wallace","sequence":"additional","affiliation":[{"name":"Maternal Fetal Medicine Unit Monash Medical Centre Southern Health Clayton Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology The Ritchie Centre Monash Institute of Medical Research Southern Clinical School Monash University Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L Jane","family":"Mcneilage","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology Monash Medical Centre Southern Health Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Manolitsas","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology Monash Medical Centre Southern Health Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan J","family":"Hodges","sequence":"additional","affiliation":[{"name":"Maternal Fetal Medicine Unit Monash Medical Centre Southern Health Clayton Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology The Ritchie Centre Monash Institute of Medical Research Southern Clinical School Monash University Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,1,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.12.074"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182051db2"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.02037.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000136086.78099.0f"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000207559.15715.98"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2007.00619.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70117-5"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2006.07.050"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ogx.0000271133.27011.05"},{"key":"e_1_2_8_11_1","first-page":"221","article-title":"Partial placenta increta and methotrexate therapy: three case reports","volume":"35","author":"Pinho S","year":"2008","journal-title":"Clin Exp Obstet Gynecol"},{"key":"e_1_2_8_12_1","unstructured":"NHMRC.When does quality assurance in health care require independent ethical review? 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