Placenta accreta: Is there a place for over sewing of placental site?

Placenta accreta is a cause of life threatening hemorrhage. Hysterectomy is the traditional treatment. Over sewing placental site were introduced to preserve fertility but its place is not clear. 25 patients with placenta accreta had been treated, during period of 12 month, in Medical City. Over sewing of the placental site were tried in ten cases. Six women out of ten preserve their reproductive function with over sewing sutures. Over sewing of placental site showed some effect in some patients who had focal placenta accreta

effect of valvular heart diseases on maternal and fetal outcome of pregnancy

Profound hemodynamic alterations occur during pregnancy, labour and in the postpartum period. These changes can adversely affect both maternal and fetal outcome, if a women encounter a valvular heart disease during her pregnancy. We try to evaluate the effect of valvular heart disease on maternal and fetal outcome of pregnancy. This is a cross section descriptive study, carried out in Baghdad teaching hospital, throughout the period from September 2007 to October 2008. Seventy eight pregnant women with valvular heart diseases, in labour, were enrolled in this study. Their medical and obstetrical records were reviewed on admission. We looked for maternal outcome after delivery [method of delivery, heart failure, arrhythmia, need for medication and period of hospitalization], additional to fetal outcome [prematurity, viability and birth weight]. Mitral valve disease is predominate valvular heart disease in pregnancy, most of them of mild severity. All maternal and fetal outcome parameters adversely increase among pregnant women with valvular heart diseases. Valvular heart diseases carried a higher risk for both mother and fetus. The risk related directly to severity of valvular heart diseases