Progressive Devascularization: A Novel Surgical Approach for Placenta Previa

Autor: Antonio F. Saad, Nathan Kirsch, George R. Saade, Gary D. V. Hankins
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: American Journal of Perinatology Reports, Vol 08, Iss 04, Pp e223-e226 (2018)
Druh dokumentu: article
ISSN: 2157-6998
2157-7005
DOI: 10.1055/s-0038-1673373
Popis: Abstract Background The gold standard for antenatal diagnosis of placenta previa is the transvaginal ultrasonography. In placenta previa cases, separation of placental and uterine tissues is challenging even for the most experienced surgeons. Life-threatening obstetrical complications from cesarean deliveries with placenta previa include peripartum hemorrhage, coagulopathy, blood transfusion, peripartum hysterectomy, and multiple organ failure. Cases We detailed the 3 cases of placenta previa that underwent bilateral uterine artery ligation; if hemostasis was not achieved, horizontal mattress sutures were placed in the lower uterine segment. All patients were discharged with minimal morbidity. Conclusion For patients with placenta previa and low risk for placenta creta, counseling should include the risk for maternal morbidity and criteria for pursuing peripartum hysterectomy. Our devascularization, a stepwise surgical approach, shows promising outcomes in placenta previa cases. Précis We propose a novel surgical approach, using a progressive devascularization surgical technique, for management of women with placenta previa, undergoing cesarean delivery.
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