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Conservative stepwise surgical approach for management of placenta previa accreta: A prospective case series study
- Source :
- International Journal of Gynecology & Obstetrics. 157:383-390
- Publication Year :
- 2021
- Publisher :
- Wiley, 2021.
-
Abstract
- Objective To describe a stepwise surgical approach for conservative management of placenta previa accreta to preserve the uterus and to evaluate the efficacy and safety of this approach in controlling postpartum hemorrhage including intrapartum hemorrhage. Methods A prospective case series study conducted on 62 pregnant women with one or more cesarean deliveries diagnosed with placenta previa accreta between January 2018 and June 2019 at Ain Shams University Maternity Hospital. All participants underwent a conservative stepwise surgical approach through Pfannenstiel skin incision with fetal delivery through a uterine incision just above the upper border of the placenta, followed by bilateral uterine artery ligation with myometrial excision of the remaining adherent placenta and cervico-isthmic sutures by MMG (the main surgeon) and MS. Results Among 62 women, the surgical approach was successful in controlling postpartum hemorrhage and preserving the uterus in 50 (80.64%) participants. Three women (4.83%) had urinary bladder injuries, all were managed intraoperatively during the cesarean section. Five women (8%) had postpartum pyrexia and five women (8%) had postpartum endometritis, all were managed conservatively with broad-spectrum antibiotics. Conclusion The stepwise surgical approach can be applied to the conservative management of placenta previa accreta to avoid unnecessary cesarean hysterectomy.
- Subjects :
- medicine.medical_specialty
Placenta Previa
Uterus
Placenta Accreta
Hysterectomy
Pregnancy
Placenta
medicine.artery
medicine
Humans
Uterine artery
reproductive and urinary physiology
Retrospective Studies
Postpartum Pyrexia
Urinary bladder
Cesarean Section
Obstetrics
business.industry
Postpartum Hemorrhage
Obstetrics and Gynecology
General Medicine
medicine.disease
Placenta previa
medicine.anatomical_structure
Female
business
Postpartum Endometritis
Case series
Subjects
Details
- ISSN :
- 18793479 and 00207292
- Volume :
- 157
- Database :
- OpenAIRE
- Journal :
- International Journal of Gynecology & Obstetrics
- Accession number :
- edsair.doi.dedup.....90eb2c6c26f099b082bcbda40ecd5d52