Background: Abnormal PLACENTAl invasion has increased parallel with persistent rise in Caesarean delivery. Management relies on accurate diagnosis and delivery should be planned at an institution with appropriate expertise and resources for managing this condition.Case: We present a case of a PLACENTA invasion anomaly which is the major risk factors of peripartum deaths. In this case we try to explain our approach which reduces unnecessary hysterectomy rates.Conclusion: In order to avoid postpartum hemorrhage and hysterectomy protocols, our approach which consists bilateral hypogastric arterial ligation, Bakri balloon tamponade and If necessary methotrexate therapy can be applied succesfully.

Dear Editor, PLACENTA PREVIA (PP) probably inhibits the development of preeclampsia (PE) during pregnancy (1, 2) and the presence of PE decreases the incidence of PP (2, 3). It could be because of different etiologies and mechanisms of PP against PE (1, 3). PE is defined as a hypertensive disease during pregnancy that is related to a disorder in the PLACENTA and vascular endothelium (1, 4). PP is the obstruction of the internal os of the cervix by the abnormally implanted PLACENTA (2, 5)....

Background: PLACENTA PREVIA (PP) is an obstetric complication that can affect maternal and fetal morbidity and mortality. Its prevalence is rising due to cesarean sections. There is no quantitative data of PLACENTA in PP. In this study, quantitative parameters of PLACENTA in cases with PP in comparison with normally implanted controls were investigated.Methods: In this quasi experimental study, PLACENTAs from pregnancies with PP and normally implanted controls (n=10) were obtained from women who underwent cesarean section. Three full-thickness columns of each PLACENTA were sampled using systematic uniform random sampling (SURS). Columns were cut into slices and slices were sectioned with 4 mm thickness. SURS selected sections were stained by Masson’s trichrome. Stereological analysis was done on 8-10 SURS microscopic fields of each section. Absolute volume and volume density of chorionic villi, inter-villous space, syncytiotrophoblast, fibrin and blood vessels in chorionic villi were estimated in both groups. Statistical analysis was done using Mann Whitney-U test and significant level was set at p<0.05.Results: There was a significant reduction in total volume and volume density of fibrin deposits on the surface of chorionic villi (p<0.05), and a significant increment in total volume and volume density of chorionic villous blood vessels in PP group in comparison with C group (p<0.05).Conclusion: Results showed that impairment in situation of implantation in PP can cause significant changes in the structure of PLACENTA. These changes probably can be influential on the evolution and survival of fetus.

Background: We studied the possible advantages of feed-forward control nursing model in the treatment of PLACENTA PREVIA.Methods: We enrolled 60 pregnant women who were receiving treatment for expectant PLACENTA PREVIA between Jan-uary 2010 and January 2016 and randomly divided them into the control group and the observation group with 30 cases in each group. In the control group, we offered specialist nursing which included examination, body positioning, vaginal bleeding record, psychological consultation and medication observation. Feed-forward control nursing was applied in the observation group which included establishing feed-forward control nursing improvement team, con-ducting quality control of nursing defects and putting forward ideas for improvements and verifying improvement outcomes.Results: The observation group got significantly higher success rate and lower complication rate compared with con-trol group. Gestational age and fetal weights improved apparently in the observation group. When we compared the amount of postpartum bleeding and pregnancy bleeding in two groups we did not find any statistically significant dif-ference (P>0.05). Patients’ satisfaction rate toward our nursing services was much higher in the observation group and the rate of nursing errors was significantly lower in this group. All differences were statistically significant (P<0.05).Conclusion: Application of feed-forward control nursing model in the expectant treatment of PLACENTA PREVIA can improve treatment success rate, decrease complications and upgrade nursing quality.

PLACENTA PREVIA is one of the common causes of third trimester obstetrical hemorrhage and the latter is an important cause of maternal mortality specially in developing countries. The aim of this study was to determine the frequency of PLACENTA PREVIA and related factors in pregnant women attending emergency maternity centers of Kerman during 1998. 1560pregnants with gestational age of 28 weeks of more were studied. Data on maternal age, parity, gravidity, blood group, gestational age, clinical presentation, history of previous cesarean section and abortion and perinatal mortality within 24 hours of delivery were analysed due to PLACENTA PREVIA. Only 15 had PLACENTA PREVIA according to the sonographic reports. Maternal age, gravidity and parity had relationship with PLACENTA PREVIA and with increasing these factors the prevalence of PLACENTA PREVIA was increased. Gestational age had also significant relationship with PLACENTA PREVIA, which means more possibility of PLACENTA PREVIA in lower gestational age. 9 cases of placenat PREVIA attended with chief complaint of vaginal bleeding. Statistical analysis showed that blood group B is a significant risk factor for developing PLACENTA PREVIA (OR= 3.8). There was no relationship between history of abortion, cesarean section and PLACENTA PREVIA. The prevalence of PLACENTA PREVIA in Kerman is slightly more than other regions of the world and its relationship with above can bear a significant effect on forecoming studies.      

Objectives: PLACENTA accreta spectrum (PAS) is a serious complication of pregnancy with maternal and fetal morbidity and mortality. Ultrasonography is a useful application in the prenatal diagnosis of PAS disorders. The main scope of this study was to assess the peak systolic velocity (PSV) of subPLACENTAl blood flow and its correlation with the clinical description of PAS disorders. Materials and Methods: In this cross-sectional study, 60 pregnant women with persistent anterior PLACENTA PREVIA in the third trimester of pregnancy were examined by color Doppler and grayscale ultrasonography for the diagnosis of PAS disorders. The PSV and resistive index (RI) of the subPLACENTAl blood flow were measured by spectrum Doppler in the anterior wall of the inferior uterine segment. Eventually, the patients were followed up until delivery and the correlation between PSV, RI, and PAS disorders was assessed post-surgery. Results: A total of 26 (43. 3%) out of 60 patients was diagnosed with PAS disorders. In cases with PAS disorders, the PSV of the subPLACENTAl blood flow was significantly higher (AUC = 0. 94, 95% CI = 0. 89-1. 00) compared to the not affected ones. In addition, the PSV of ≥ 43. 65 cm/sec with 100% specificity was determined as the optimal cut-off for the prenatal diagnosis of PAS disorders. Finally, the RI of subPLACENTAl blood flow showed no significant difference between the two groups (AUC = 0. 551, 95% CI = 0. 398-0. 705). Conclusions: Overall, the measurement of the PSV of the subPLACENTAl blood flow in patients with anterior PLACENTA PREVIA can increase the accuracy of the ultrasound diagnosis of PAS disorders.