Urinary tract injuries during treatment of patients with morbidly adherent placenta
| Autor: | Juan Gabriel de Ríos-Posada, Albaro José Nieto-Calvache, María Camila López-Girón, Luis Alberto Plazas-Córdoba, Margarita María Chancy-Castaño, M. Lili Ceballos-Posada, Adriana Messa-Bryon, Manuel Duque-Galán |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Morbidly adherent placenta Placenta accreta Placenta Urinary system Placenta Accreta Hysterectomy urologic and male genital diseases Urologic Surgical Procedure 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans 030212 general & internal medicine Urinary Tract Retrospective Studies 030219 obstetrics & reproductive medicine Cesarean Section business.industry Obstetrics and Gynecology bacterial infections and mycoses medicine.disease female genital diseases and pregnancy complications Surgery Pediatrics Perinatology and Child Health Female business Urinary bladder disease Complication Placenta Diseases |
| Zdroj: | The Journal of Maternal-Fetal & Neonatal Medicine. 34:3140-3146 |
| ISSN: | 1476-4954 1476-7058 |
| Popis: | Urinary tract injuries (UTI) are a frequent complication of morbidly adherent placenta (MAP) management. In this study, we aim to characterize the type of UTI that occurs and to define if their incidence varies after establishing a fixed interdisciplinary group for the protocolized management of patients with MAP.All patients with confirmed MAP attended between 2011 and 2019 in our institution, were included. We analyzed the effect of a change in the surgical protocol including rigid ureteral catheters, vesicouterine dissection before hysterotomy and interdisciplinary planning, in the bladder or ureteral injuries incidence.The study included 65 women. UTI was identified in 27.7% of patients and was associated with a greater volume of blood loss, transfusion requirement, hospital stay, and the need for additional surgeries. There was a high frequency of UTI in patients without protocolized management. The use of rigid ureteral catheters and retrovesical dissection before hysterotomy were associated with a less ureteral injury.Developing expertise among the members of the surgical team is essential to improve results. Using rigid ureteral catheters, performing retrovesical dissection before hysterotomy, and performing less extensive surgeries in selected patients are associated with a low frequency of ureteral injuries. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|