Attuali orientamenti nella diagnosi e nel trattamento delle aderenze placentari patologiche: la nostra esperienza

The abnormal adherence of the placenta is a disease characterized by an anomalous miometrial infiltration of Chorionic villi. This event blocks the regular detachment of placenta in post partum and sometimes a severe bleeding that causes the urgency of a caesarean section. In the past years the incidence of this pathology has increased to about 1 in 500/600 deliveries. The cause of abnormal adherence of placenta is unknown but there are some risk factors such as prior caesarean sections, women older than 35 years of age and placenta previa. The early diagnosis is very important and it can be done by Eco-Color-doppler (eventually associated with 3d technique) and Magnetic Resonance. Objective. To understand if the risk factors of our assay are the same as other international trials, in particular to compare our data with a study executed by University of Chicago during the period 1998-2003. Study Design. This study considers 3958 deliveries in Obstetrics and Gynecology Division of Palermo University Polyclinic during the period 2002-2007. We consider abnormal infiltration from accreta to percreta excluding simple adherent placenta. Our results confirm the increasing incidence of abnormal adherence of placenta, in our Department it is about 1/396 deliveries. Results: The risk factors are prior caesarean sections, women older than 35 years of age and placenta previa like other trials. We observed that some diseases associated to an anomalous placenta angiostructure like preeclampsia or gestational diabetes could be considered important risk factors