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Ureter injury in obstetric hysterectomy with placenta accreta spectrum: Case report☆
- Source :
- International Journal of Surgery Case Reports
- Publication Year :
- 2021
- Publisher :
- Elsevier, 2021.
-
Abstract
- Introduction and importance Placenta accreta spectrum (PAS) is a state of abnormal attachment of the placenta, including placenta accreta, placenta increta, and placenta percreta. This condition can be life-threatening due to the placenta cannot spontaneously separated, resulting in continuous bleeding. Cesarean section followed by hysterectomy is one of the treatment options for PAS. There was a great liability for urinary tract injuries during the operation of PAS patient. Case presentation We present the case of ureter injury during subtotal hysterectomy in patient with PAS. A 30-years-old female patient was diagnosed with recurrent antepartum hemorrhage due to placenta previa accreta spectrum on G2P1 33 weeks of gestational age, singleton live breech presentation, previous c-section 1×. After uterine transverse incision, the baby was delivered. We decided to perform subtotal hysterectomy. There was severe adhesion. On the exploration after subtotal hysterectomy was performed, we found ruptured of the right ureter. Clinical discussion Hysterectomy peripartum is one of the treatment of PAS, either to prevent or to control postpartum hemorrhage. In pregnant women with morbid placental adherence, there was a great liability for urinary tract injuries. Distal ureters are the most commonly injured while hysterectomy. Injuries to the ureters in this patient occurred due to severe adhesions and unclear visual organ. Conclusion Although it is rare, ureter injury may occur during subtotal hysterectomy in patient with placenta accreta spectrum. To prevent that condition, inserting ureter stent can be perform before the operation. Multidisciplinary approach is carried out so that patient outcomes are good.<br />Highlights • Ureter injury in obstetrics hysterectomy: case report • Ureter injury in placenta accreta spectrum • Ureter injury in obstetric hysterectomy with placenta accreta spectrum
- Subjects :
- medicine.medical_specialty
Hysterectomy
Ureter injury
Antepartum hemorrhage
Placenta accreta
business.industry
Placenta Percreta
medicine.medical_treatment
Urinary system
Gestational age
Case Report
Placenta accreta spectrum
medicine.disease
Placenta previa
Surgery
medicine.anatomical_structure
Placenta
Subtotal hysterectomy
medicine
business
reproductive and urinary physiology
Subjects
Details
- Language :
- English
- ISSN :
- 22102612
- Volume :
- 88
- Database :
- OpenAIRE
- Journal :
- International Journal of Surgery Case Reports
- Accession number :
- edsair.doi.dedup.....71a7da5710e16747c88229d76c26ab3b