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The effectiveness of double incision technique in uterus preserving surgery for placenta percreta.

作者信息

Polat Ibrahim, Yücel Burak, Gedikbasi Ali, Aslan Halil, Fendal Aysun

机构信息

Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.

出版信息

BMC Pregnancy Childbirth. 2017 Apr 27;17(1):129. doi: 10.1186/s12884-017-1262-3.

DOI:10.1186/s12884-017-1262-3
PMID:28449642
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5406983/
Abstract

BACKGROUND

Placenta percreta is a life-threatening condition that places patients at risk of massive bleeding. It necessitates very complicated surgery and can result in mortality. Caesarean hysterectomy is the accepted procedure worldwide; however, recent studies discussing conservative treatment with segmental resections have been published. Foetal extraction and segmental resection can be performed through the same incision (single uterine incision) or through two different incisions (double uterine incision). In this study, we aimed to evaluate the effectiveness and results of the double incision technique.

METHODS

Twenty-two patients with a diagnosis of placenta percreta who underwent conservative surgery were included. Segmental resection was performed via single incision in ten patients and double incision in twelve patients.

RESULTS

There was no difference between the patients who underwent segmental resection via single and double incision in terms of age, gravida, number of previous caesarean deliveries, gestational age at delivery, or rate of elective surgeries. The operation time, transfusion requirement, intensive care unit admission, total hospitalization and success of conservative surgery were comparable between the groups.

CONCLUSIONS

Based on the outcomes of our study, double uterine incision allows for the safe extraction of the foetus during uterus-preserving surgery in patients with placenta percreta without worsening the results compared to single uterine incision.

TRIAL REGISTRATION

NCT02702024 , Date of registration: February 26, 2016, retrospectively registered.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fa7/5406983/332e71dcaf49/12884_2017_1262_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fa7/5406983/e2467d2c9ac4/12884_2017_1262_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fa7/5406983/bc2612d7f865/12884_2017_1262_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fa7/5406983/326d2f733e84/12884_2017_1262_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fa7/5406983/8e7aa3c1e948/12884_2017_1262_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fa7/5406983/332e71dcaf49/12884_2017_1262_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fa7/5406983/e2467d2c9ac4/12884_2017_1262_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fa7/5406983/bc2612d7f865/12884_2017_1262_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fa7/5406983/326d2f733e84/12884_2017_1262_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fa7/5406983/8e7aa3c1e948/12884_2017_1262_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fa7/5406983/332e71dcaf49/12884_2017_1262_Fig5_HTML.jpg

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本文引用的文献

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The recurrence risk of placenta accreta following uterine conserving management.子宫保留治疗后胎盘植入的复发风险
J Neonatal Perinatal Med. 2015;8(4):293-6. doi: 10.3233/NPM-15915028.
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What should we do to optimise outcome in twin pregnancy complicated with placenta percreta? A case report.对于合并胎盘植入的双胎妊娠,我们应采取什么措施来优化结局?病例报告。
BMC Pregnancy Childbirth. 2015 Nov 5;15:289. doi: 10.1186/s12884-015-0714-x.
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Conservative management of morbidly adherent placenta: expert review.胎盘植入的保守治疗:专家综述
在胎盘植入谱系疾病中进行局部子宫切除术并放置Bakri球囊。
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Parallel transverse uterine incisions, a novel approach for managing heavy hemorrhage and preserving the uterus: A retrospective cohort study for patients with anterior placenta previa and accreta.平行横向子宫切口:一种治疗严重出血并保留子宫的新方法:一项针对前置胎盘合并植入患者的回顾性队列研究
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Comments on: Conservative Surgical Treatment of a Case of Placenta Accreta.关于:胎盘植入一例的保守性外科治疗的评论
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Conservative Surgical Treatment of a Case of Placenta Accreta.1例胎盘植入病例的保守性手术治疗
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Successful anticoagulant therapy for disseminated intravascular coagulation during conservative management of placenta percreta: a case report and literature review.胎盘植入保守治疗期间弥漫性血管内凝血的成功抗凝治疗:病例报告及文献复习。
BMC Pregnancy Childbirth. 2017 Dec 29;17(1):443. doi: 10.1186/s12884-017-1634-8.
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