Departments of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan.
Acta Obstet Gynecol Scand. 2013 Apr;92(4):372-7. doi: 10.1111/aogs.12074. Epub 2013 Feb 12.
For cesarean hysterectomy with placenta previa accreta, "universally achievable" measures are required. We propose eight measures: (i) placement of intra-iliac arterial occlusion balloon catheters; (ii) placement of ureter stents; (iii) "holding the cervix" to identify the site to be transected; (iv) uterine fundal incision; (v) avoidance of uterotonics; (vi) "M cross double ligation" for ligating the ovarian ligament; (vii) "filling the bladder" to identify the bladder separation site and "opening the bladder" for placenta previa accreta with bladder invasion; and (viii) to continue to clamp the medial side of the parametrium or the cervix or employment of the "double edge pick-up" to ligate it. These eight measures are simple, easy, effective, and thus "universally achievable".
对于合并胎盘植入的剖宫产子宫切除术，需要采取“普遍可行”的措施。我们提出八项措施：（i）放置髂内动脉阻塞球囊导管；（ii）放置输尿管支架；（iii）“握住子宫颈”以确定要切开的部位；（iv）子宫底部切口；（v）避免使用子宫收缩剂；（vi）“M 形交叉双结扎”用于结扎卵巢韧带；（vii）“充盈膀胱”以识别膀胱分离部位，以及对于合并膀胱侵犯的胎盘植入，“打开膀胱”；以及（viii）继续夹闭子宫旁组织或子宫颈的内侧，或采用“双边夹取”来结扎。这八项措施简单、易用、有效，因此是“普遍可行”的。
