401. Placenta percreta with a vaginal fistula after successful management by uterine transverse fundal incision and subsequent cesarean hysterectomy
- Author
-
Eiichi Morii, Kazuya Mimura, Tomomi Egawa-Takata, Takeshi Kanagawa, Tadashi Kimura, Satoko Matsuzaki, Yutaka Ueda, and Shinya Matsuzaki
- Subjects
medicine.medical_specialty ,Pregnancy ,Vaginal fistula ,Obstetrics ,business.industry ,Placenta accreta ,Placenta Percreta ,Obstetrics and Gynecology ,Case Report ,medicine.disease ,Maternal-Fetal Medicine ,Surgery ,Placenta previa ,medicine.anatomical_structure ,Obstetrics and gynaecology ,Cesarean hysterectomy ,Placenta ,embryonic structures ,medicine ,business ,Uterine transverse fundal incision ,reproductive and urinary physiology - Abstract
Placenta previa presents a highest risk to pregnancy, and placenta accreta is the most serious. Placenta accreta requires cesarean delivery and often results in massive obstetric hemorrhage and higher maternal morbidity. Challenges associated with cesarean delivery techniques may contribute to increased maternal blood loss and morbidity rates. Several recent obstetric studies reported the usefulness of transverse uterine fundal incision for managing placenta accreta. We present a case of placenta percreta that was treated by a transverse fundal incision. We successfully avoided cutting through the placenta and helped decrease maternal blood loss. After delivery, the patient underwent a cesarean hysterectomy. Postoperative day 48, she experienced watery discharge and was diagnosed with vaginal fistula. We present our case and review the literature.
- Published
- 2014