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Yara N, Kinjyo Y, Chinen Y, Kinjo T, Mekaru K. Placenta Accreta Spectrum with Ureteral Invasion due to Progression of Cesarean Scar Pregnancy. Case Rep Obstet Gynecol 2023; 2023:9065978. [PMID: 37840656 PMCID: PMC10576643 DOI: 10.1155/2023/9065978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/14/2023] [Accepted: 09/16/2023] [Indexed: 10/17/2023] Open
Abstract
Expectant management is not recommended for cesarean scar pregnancies because they are often associated with placenta accreta, cesarean hysterectomy, and massive life-threatening hemorrhages during delivery. Herein, we report a case of placenta accreta spectrum with ureteral invasion due to the progression of a cesarean scar pregnancy. Case. A 41-year-old woman, with a history of three cesarean sections and two miscarriages, was referred to our hospital at 25 weeks of gestation with a diagnosis of placenta accreta spectrum and bladder invasion. Although the gestational sac was located anterior to the lower uterine segment, a cesarean-scar pregnancy was not diagnosed. A cesarean hysterectomy was performed at 31 weeks of gestation with the placement of an aortic balloon. The placenta was found to adhere to the ureter with more than the expected parenchymal tissue displacement (FIGO Classification 3b). The ureter was not obstructed and was preserved by leaving the placenta slightly on the ureteral side. Postoperatively, a ureteral stent was placed because of the ureteral stricture in the area where the placenta had adhered. Two months after surgery, the ureteral stent was removed after observing an improvement in stenosis. An adherent placenta due to continued cesarean scar pregnancy should be managed by assuming placental invasion beyond the parenchyma into the ureter.
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Affiliation(s)
- Nana Yara
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, Japan
| | - Yoshino Kinjyo
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, Japan
| | - Yukiko Chinen
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, Japan
| | - Tadatsugu Kinjo
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, Japan
| | - Keiko Mekaru
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, Japan
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Singh G, Sabnani S, Navriya SC, Panda S, Gaurav A. Monstrous Invasion of Placenta Percreta and Previa: Multidisciplinary Management of a Case, the Role of a Urologist, and a Literature Review. Cureus 2022; 14:e28537. [PMID: 36185834 PMCID: PMC9518697 DOI: 10.7759/cureus.28537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2022] [Indexed: 11/26/2022] Open
Abstract
In rare situations, pregnant women may experience life-threatening bleeding due to the placenta’s aberrant invasion of the bladder. A 28-year-old pregnant female with two previous cesarean deliveries presented with the chief complaint of abdominal pain at the earlier scar site. Ultrasound imaging was suggestive of placenta percreta with bladder invasion. The patient underwent elective cesarean section with a uterine-preservation strategy. A healthy male baby was delivered by classical cesarean section, and bilateral uterine artery ligation was done. The patient developed severe postoperative hemorrhage, for which she was re-explored, and the urology team was called for intraoperative assistance. The area of placental invasion into the bladder was resected entirely with bladder reconstruction. Placenta percreta is a life-threatening condition that can involve adjacent uterine structures. Successful management involves a multidisciplinary strategy involving experienced obstetricians, urologists, anesthesiologists, blood bank teams, and neonatologists.
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Posterior Placenta Accreta Spectrum Disorders: Risk Factors, Diagnostic Accuracy, and Surgical Management. MATERNAL-FETAL MEDICINE 2021. [DOI: 10.1097/fm9.0000000000000124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Manidip P, Soma B. Cesarean bladder injury - obstetrician's nightmare. J Family Med Prim Care 2020; 9:4526-4529. [PMID: 33209757 PMCID: PMC7652199 DOI: 10.4103/jfmpc.jfmpc_586_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/10/2020] [Accepted: 06/24/2020] [Indexed: 11/04/2022] Open
Abstract
Urinary bladder is an adjacent viscus susceptible for intraoperative injury during cesarean section (CS). Prolonged labor, scarred uterus, intraabdominal adhesion, emergency CS, advanced labor, cesarean hysterectomy etc., are the predisposing factors for bladder injury during CS. While operating on such conditions, one should be meticulous to explore the possibility of bladder injury. Family physician practicing community obstetrics should be aware of this and know how to tackle this. Usually the dome of the bladder is injured and the trigonal area remains away from the injury field by 6-10 cm. Bladder rent is repaired in two layers either by continuous simple or interrupted suture with 3-0 & 2-0 polyglycolic acid suture. Suprapubic cystostomy and transurethral catheter are kept for 10-14 days. While postoperative adhesion, CS during full dilatation of cervix, abnormal anatomy etc., may not proceed for negligence, bladder injury in normal patients and unrecognized intraoperative bladder injury may attract penalty from the consumer court.
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Affiliation(s)
- Pal Manidip
- Department of Obstetrics and Gynaecology, College of Medicine and JNM Hospital, WBUHS, Kalyani, Nadia, West Bengal, India
| | - Bandyopadhyay Soma
- Department of Obstetrics and Gynaecology, Katihar Medical College, Katihar, Bihar, India
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Palacios-Jaraquemada JM, D'Antonio F, Buca D, Fiorillo A, Larraza P. Systematic review on near miss cases of placenta accreta spectrum disorders: correlation with invasion topography, prenatal imaging, and surgical outcome. J Matern Fetal Neonatal Med 2019; 33:3377-3384. [PMID: 30700221 DOI: 10.1080/14767058.2019.1570494] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpose of the article: Placental accreta spectrum (PAS) is the most dangerous iatrogenic complication of cesarean potentially leading to massive intra-partum haemorrhage and death. Despite this, identification of near miss cases of PAS has not been consistently reported in the published literature. The aim of this systematic review was to explore prenatal and surgical characteristics of near miss cases of PAS disorders.Materials and methods: Medline, Embase, CINAHL, SciELO, and Cochrane databases were searched. Only studies including near miss cases of PAS disorders in which a detailed description of the clinical course, severity of placental invasion, role of prenatal imaging, and surgical management were considered eligible for the inclusion in the present systematic review. Random-effect meta-analyses of proportions were used to pool the data.Results: Thirty-four studies were included in the systematic review. The incidence of placenta accreta, increta, and percreta in near miss cases of PAS disorders was 0% (95% CI 0-24.6), 17.3% (95% CI 8.4-28.6) and 82.7% (95% CI 71.4-91.6). S1 invasion, defined as invasion in the upper posterior bladder wall was present in none of the near miss cases of PAS while all included cases showed S2 invasion. Prenatal imaging, either ultrasound or magnetic resonance imaging, detected invasive placenta in 54.4% (95% CI 41.0-67.5). Clinical symptoms occurred in 65.3% (95% CI 52.1-77.4) of near miss cases of PAS before surgery, while the corresponding figures for symptoms occurring during and after surgery were 65.5% (95% CI 52.2-77.5) and 50.0% (95% CI 36.5-63.5) of cases, respectively. Invasion in the inferior part of the lower uterine segment, posterior bladder and parametria was associated with a high risk of morbidity.Conclusion: Near miss cases of PAS are commonly associated with posterior bladder or parametrial invasion and placenta percreta. Further studies are needed in order to identify women affected by PAS disorders at high risk of surgical complications.
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Affiliation(s)
- Jose M Palacios-Jaraquemada
- Center for Medical Education and Clinical Research (CEMIC), University Hospital, Buenos Aires, Argentina.,School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Francesco D'Antonio
- Department of Obstetrics and Gynecology, University Hospital of Northern Norway, Tromsø, Norway.,Department of Clinical Medicine, Faculty of Health Sciences, Women's Health and Perinatology Research Group, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Danilo Buca
- Department of Obstetrics and Gynaecology, G. d' Annunzio University of Chieti, Chieti, Italy
| | - Angel Fiorillo
- Center for Medical Education and Clinical Research (CEMIC), University Hospital, Buenos Aires, Argentina
| | - Pilar Larraza
- School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
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Özcan HÇ, Balat Ö, Uğur MG, Sucu S, Tepe NB, Kazaz TG. Use of Bladder Filling to Prevent Urinary System Complications in the Management of Placenta Percreta: a Randomized Prospective Study. Geburtshilfe Frauenheilkd 2018; 78:173-178. [PMID: 29479114 PMCID: PMC5818277 DOI: 10.1055/s-0044-100039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 12/27/2017] [Accepted: 12/28/2017] [Indexed: 10/29/2022] Open
Abstract
Introduction The aim of our study was to evaluate the effect of filling the bladder on peripartum genitourinary injuries (especially bladder complications) in women with placenta percreta and to compare patient characteristics. Material and Methods Our prospective cohort study consisted of pregnant women with placenta percreta who underwent planned cesarean hysterectomy at the Department of Obstetrics and Gynecology of Gaziantep University Hospital between January 2015 and July 2016. Bladders were filled with 300 ml saline solution to determine surgical borders better and enable dissection of the lower uterine segment without excessive bleeding or unintended injury. Results A total of 66 women were included in the study: 32 women whose bladders were filled during surgery (filled-bladder group) and 34 women whose bladders were not filled (not filled-bladder group). Comparisons of demographic and obstetrical data, surgical parameters, the need for transfusion, and bladder injury rates revealed no significant differences between the two groups. We did not observe any beneficial effect of filling the bladder on preventing urinary complications compared with the women whose bladders were not filled (p = 0.339). Conclusions Filling the bladder with saline solution and mobilization of the bladder from the lower uterine segment did not have a statistically significant beneficial effect on preventing complications of the genitourinary system. But although the beneficial effects were not significant, shorter operation times, shorter postoperative hospital stays, and fewer bladder injuries were noted in patients whose bladders were filled.
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Affiliation(s)
- Hüseyin Çağlayan Özcan
- Gaziantep University, School of Medicine, Dept. of Obstetrics and Gynecology, Gaziantep, Turkey
| | - Özcan Balat
- Gaziantep University, School of Medicine, Dept. of Obstetrics and Gynecology, Gaziantep, Turkey
| | - Mete Gurol Uğur
- Gaziantep University, School of Medicine, Dept. of Obstetrics and Gynecology, Gaziantep, Turkey
| | - Seyhun Sucu
- Gaziantep University, School of Medicine, Dept. of Obstetrics and Gynecology, Gaziantep, Turkey
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Lekic Z, Ahmed E, Peeker R, Sporrong T, Karlsson O. Striking decrease in blood loss with a urologist-assisted standardized multidisciplinary approach in the management of abnormally invasive placenta. Scand J Urol 2017; 51:491-495. [DOI: 10.1080/21681805.2017.1352617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Zeljka Lekic
- Department of Anesthesiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ehab Ahmed
- Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ralph Peeker
- Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tommy Sporrong
- Department of Obstetrics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ove Karlsson
- Department of Anesthesiology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Camuzcuoglu A, Vural M, Hilali NG, Incebiyik A, Yuce HH, Kucuk A, Camuzcuoglu H. Surgical management of 58 patients with placenta praevia percreta. Wien Klin Wochenschr 2016; 128:360-6. [PMID: 26913862 DOI: 10.1007/s00508-016-0962-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 01/21/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study is to present our experience with surgical management of placenta praevia percreta. METHODS This study was conducted from January 2009 through March 2014 at Harran University Hospital and was a chart review of all patients who underwent caesarean hysterectomy with the placenta left in situ for placenta praevia percreta. RESULTS The study group comprised 58 patients. All of the patients underwent ultrasound mapping of the placental area before surgery. Emergent caesarean hysterectomy was only performed in 9 patients; 49 patients underwent planned caesarean hysterectomy. Bilateral internal iliac artery ligation was performed in all cases. Four patients (6.9 %) had bladder damage, one patient (1.7 %) required cystotomy, and one patient (1.7 %) required re-operation because of postoperative hemorrhage. The mean operative time was 141.6 (range: 95-355) minutes. Only 17 (29.3 %) patients were administered more than four units of red blood cells. There was no ureteral damage or maternal death. Furthermore, there were no complications in 42 (72.4 %) patients. CONCLUSIONS Caesarean hysterectomy for placenta praevia percreta is associated with increased maternal morbidity. However, preoperative diagnosis of placenta praevia percreta, ultrasound mapping of the placenta, and the presence of a multidisciplinary experienced team may decrease maternal morbidity and mortality. Moreover, the urinary system may be protected in the patients with placenta praevia percreta without serious morbidity.
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Affiliation(s)
- Aysun Camuzcuoglu
- Department of Obstetrics & Gynaecology, School of Medicine, Mugla Sitki Kocman University, 48000, Mugla, Turkey.
| | - Mehmet Vural
- Department of Obstetrics & Gynaecology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Nese Gul Hilali
- Department of Obstetrics & Gynaecology, Harran University, Sanliurfa, Turkey
| | - Adnan Incebiyik
- Department of Obstetrics & Gynaecology, Harran University, Sanliurfa, Turkey
| | - Hasan Husnu Yuce
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Ahmet Kucuk
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Hakan Camuzcuoglu
- Department of Obstetrics & Gynaecology, School of Medicine, Mugla Sitki Kocman University, 48000, Mugla, Turkey
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Ahmed SR, Aitallah A, Abdelghafar HM, Alsammani MA. Major Placenta Previa: Rate, Maternal and Neonatal Outcomes Experience at a Tertiary Maternity Hospital, Sohag, Egypt: A Prospective Study. J Clin Diagn Res 2015; 9:QC17-9. [PMID: 26674539 DOI: 10.7860/jcdr/2014/14930.6831] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 08/28/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Major degree placenta is a serious health issue and is associated with high fetal-maternal morbidity and mortality. Literature from developing countries is scant. AIM To determine the prevalence and maternal and neonatal outcomes among women with major placenta previa (PP). MATERIALS AND METHODS A prospective descriptive study of 52 singleton pregnancies with PP was evaluated in this study. The study was conducted at Sohag University Hospital, Egypt from January through June 2014. Outcome measures, including the prevalence of PP, maternal and neonatal outcomes, and case-fatality rate. RESULTS The total number of deliveries performed during the study period was 3841, of them, 52 cases were placenta previa. Thus, the prevalence of PP was 1.3%. The mean of previous cesarean scars was 2.2±1.4. Of women with PP, 26.4% (n=14) had placenta accreta. In total, 15.1% (n=8) of women underwent an obstetric hysterectomy. From the total no. of babies, 13.2% (n=7) were delivered fresh stillborn babies. Of the surviving babies (n=45), 20% (n=9) required admission to NICU. The frequencies of bowel and bladder injuries were 3.8% (n=2) and 13.2% (n=7) respectively. There was no maternal death in this study. CONCLUSION The rate of PP is comparable to previous studies, however, the rate of placenta accreta is high. Also, there are high rates of neonatal mortality and intraoperative complications which can be explained by accreta. The study highlights the need to revise maternity and child health services.
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Affiliation(s)
- Salah Roshdy Ahmed
- Professor, Department of Obstetrics and Gynecology, Sohag University , Egypt
| | - Abdusaeed Aitallah
- Professor, Department of Obstetrics and Gynecology, Sohag University , Egypt
| | - Hazem M Abdelghafar
- Assistant Professor, Department of Obstetrics and Gynecology, Sohag University , Egypt
| | - Mohamed Alkhatim Alsammani
- Associate Professor, Department of Obstetrics and Gynecology, College of Medicine, Qassim University, Saudi Arabia & University of Bahri , Sudan
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Ibrahim MA, Liu A, Dalpiaz A, Schwamb R, Warren K, Khan SA. Urological Manifestations of Placenta Percreta. Curr Urol 2015; 8:57-65. [PMID: 26889119 DOI: 10.1159/000365691] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 12/12/2014] [Indexed: 12/19/2022] Open
Abstract
Placenta percreta is a condition of pregnancy associated with abnormal decidua placenta. It is characterized by invasion of chorionic villi past the myometrium and serosa, towards urogenital organs. Complications include massive hemorrhage, bladder dysfunction, and severe infections during delivery. Reports suggest an increasing prevalence of this condition. From a urological perspective, this review suggests how early diagnostic modalities, effective treatment plans, and appropriate surgical methods may aid in decreasing the morbidity and mortality of placenta percreta. The importance of maintaining bladder integrity during hysterectomy is emphasized.
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Affiliation(s)
- Mina A Ibrahim
- Department of Physiology and Biophysics, Stony Brook, N.Y., USA
| | - Angela Liu
- Department of Physiology and Biophysics, Stony Brook, N.Y., USA
| | - Amanda Dalpiaz
- Department of Physiology and Biophysics, Stony Brook, N.Y., USA
| | - Richard Schwamb
- Department of Physiology and Biophysics, Stony Brook, N.Y., USA
| | - Kelly Warren
- Department of Physiology and Biophysics, Stony Brook, N.Y., USA
| | - Sardar A Khan
- Department of Urology, SUNY School of Medicine, Stony Brook University, Stony Brook, N.Y., USA
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Kume K, M. Tsutsumi Y, Soga T, Sakai Y, Kambe N, Kawanishi R, Hamaguchi E, Kawahara T, Kasai A, Nakaji Y, T. Horikawa Y, Nakayama S, Kaji T, Irahara M, Tanaka K. A case of placenta percreta with massive hemorrhage during cesarean section. THE JOURNAL OF MEDICAL INVESTIGATION 2014; 61:208-12. [DOI: 10.2152/jmi.61.208] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Yasuo M. Tsutsumi
- Department of Anesthesiology, Institute of Health Bioscience, the University of Tokushima Graduate School
| | - Tomohiro Soga
- Department of Anesthesiology, Institute of Health Bioscience, the University of Tokushima Graduate School
| | - Yoko Sakai
- Department of Anesthesiology, Tokushima University Hospital
| | - Noriko Kambe
- Department of Anesthesiology, Institute of Health Bioscience, the University of Tokushima Graduate School
| | | | - Eisuke Hamaguchi
- Department of Anesthesiology, Institute of Health Bioscience, the University of Tokushima Graduate School
| | | | - Asuka Kasai
- Department of Anesthesiology, Tokushima University Hospital
| | - Yoshimi Nakaji
- Department of Anesthesiology, Tokushima University Hospital
| | - Yousuke T. Horikawa
- Department of Anesthesiology, Institute of Health Bioscience, the University of Tokushima Graduate School
| | - Souichiro Nakayama
- Department of Obstetrics and Gynecology, Institute of Health Bioscience, the University of Tokushima Graduate School
| | - Takashi Kaji
- Department of Obstetrics and Gynecology, Institute of Health Bioscience, the University of Tokushima Graduate School
| | - Minoru Irahara
- Department of Obstetrics and Gynecology, Institute of Health Bioscience, the University of Tokushima Graduate School
| | - Katsuya Tanaka
- Department of Anesthesiology, Institute of Health Bioscience, the University of Tokushima Graduate School
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Palacios-Jaraquemada JM. Caesarean section in cases of placenta praevia and accreta. Best Pract Res Clin Obstet Gynaecol 2013; 27:221-32. [DOI: 10.1016/j.bpobgyn.2012.10.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Accepted: 10/11/2012] [Indexed: 10/27/2022]
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13
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Tam Tam KB, Dozier J, Martin JN. Approaches to reduce urinary tract injury during management of placenta accreta, increta, and percreta: a systematic review. J Matern Fetal Neonatal Med 2013; 25:329-34. [PMID: 23003574 DOI: 10.3109/14767058.2011.576720] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE A systematic review of the literature was conducted to answer the following question: are there enhancements to standard peripartum hysterectomy technique that minimize unintentional urinary tract (UT) injury in pregnancies complicated by invasive placental attachment (INPLAT)? METHODS A PubMed search of English language articles on INPLAT published by June 2010 was conducted. Data regarding the following parameters was required for inclusion in the quantitative analysis of the review's objective: (1) type of INPLAT, (2) details pertaining to medical and surgical management of INPLAT, and (3) complications, if any, associated with management. An attempt was made to identify approaches that may lower the risk of unintentional UT injury. RESULTS Most cases (285 of 292) were managed by hysterectomy. There were 83 (29%) cases of unintentional UT injury. Antenatal diagnosis of INPLAT lowered the rate of UT injury (39% vs. 63%; P = 0.04). Information regarding surgical technique or medical management was available for 90 cases; 14 of these underwent a standard hysterectomy technique. Methotrexate treatment and 11 modifications of the surgical technique were associated with 16% unintentional UT injury rate as opposed to 57% for standard hysterectomy (P = 0.002). The use of ureteral stents reduced risk of urologic injury (P = 0.01). Multiple logistic regression analysis identified antenatal diagnosis as the significant predictor of an intact UT. CONCLUSIONS Antenatal diagnosis of INPLAT is paramount to minimize UT injury. Utilization of management modifications identified in this review may reduce urologic injury due to INPLAT.
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Affiliation(s)
- Kiran Babu Tam Tam
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi 39216-4505, USA
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PALACIOS-JARAQUEMADA JOSÉMIGUEL, BRUNO CLAUDIOHERNÁN, MARTÍN EDUARDO. MRI in the diagnosis and surgical management of abnormal placentation. Acta Obstet Gynecol Scand 2012; 92:392-7. [DOI: 10.1111/j.1600-0412.2012.01527.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Ng MK, Jack GS, Bolton DM, Lawrentschuk N. Placenta Percreta With Urinary Tract Involvement: The Case for a Multidisciplinary Approach. Urology 2009; 74:778-82. [DOI: 10.1016/j.urology.2009.01.071] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2008] [Revised: 01/29/2009] [Accepted: 01/29/2009] [Indexed: 11/16/2022]
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Moore LE, Gonzalez I. Placenta Percreta With Bladder Invasion Diagnosed With Sonography. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2008. [DOI: 10.1177/8756479308318335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Placenta previa, placenta accreta, and vasa previa are important causes of bleeding in the second half of pregnancy and in labor. Risk factors for placenta previa include prior cesarean delivery, pregnancy termination, intrauterine surgery, smoking, multifetal gestation, increasing parity, and maternal age. The diagnostic modality of choice for placenta previa is transvaginal ultrasonography, and women with a complete placenta previa should be delivered by cesarean. Small studies suggest that, when the placenta to cervical os distance is greater than 2 cm, women may safely have a vaginal delivery. Regional anesthesia for cesarean delivery in women with placenta previa is safe. Delivery should take place at an institution with adequate blood banking facilities. The incidence of placenta accreta is rising, primarily because of the rise in cesarean delivery rates. This condition can be associated with massive blood loss at delivery. Prenatal diagnosis by imaging, followed by planning of peripartum management by a multidisciplinary team, may help reduce morbidity and mortality. Women known to have placenta accreta should be delivered by cesarean, and no attempt should be made to separate the placenta at the time of delivery. The majority of women with significant degrees of placenta accreta will require a hysterectomy. Although successful conservative management has been described, there are currently insufficient data to recommend this approach to management routinely. Vasa previa carries a risk of fetal exsanguination and death when the membranes rupture. The condition can be diagnosed prenatally by ultrasound examination. Good outcomes depend on prenatal diagnosis and cesarean delivery before the membranes rupture.
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Affiliation(s)
- Yinka Oyelese
- Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, UMDNJ-Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, New Brunswick, New Jersey 08901-1977, USA.
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Kume K, M. Tsutsumi Y, Soga T, Sakai Y, Kambe N, Kawanishi R, Hamaguchi E, Kawahara T, Kasai A, Nakaji Y, T. Horikawa Y, Nakayama S, Kaji T, Irahara M, Tanaka K. <b>A case of placenta percreta with massive hemorrhage </b><b>during cesarean section </b>. THE JOURNAL OF MEDICAL INVESTIGATION 2000. [DOI: 10.2152/jmi.40.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Yasuo M. Tsutsumi
- Department of Anesthesiology, Institute of Health Bioscience, the University of Tokushima Graduate School
| | - Tomohiro Soga
- Department of Anesthesiology, Institute of Health Bioscience, the University of Tokushima Graduate School
| | - Yoko Sakai
- Department of Anesthesiology, Tokushima University Hospital
| | - Noriko Kambe
- Department of Anesthesiology, Institute of Health Bioscience, the University of Tokushima Graduate School
| | | | - Eisuke Hamaguchi
- Department of Anesthesiology, Institute of Health Bioscience, the University of Tokushima Graduate School
| | | | - Asuka Kasai
- Department of Anesthesiology, Tokushima University Hospital
| | - Yoshimi Nakaji
- Department of Anesthesiology, Tokushima University Hospital
| | - Yousuke T. Horikawa
- Department of Anesthesiology, Institute of Health Bioscience, the University of Tokushima Graduate School
| | - Souichiro Nakayama
- Department of Obstetrics and Gynecology, Institute of Health Bioscience, the University of Tokushima Graduate School
| | - Takashi Kaji
- Department of Obstetrics and Gynecology, Institute of Health Bioscience, the University of Tokushima Graduate School
| | - Minoru Irahara
- Department of Obstetrics and Gynecology, Institute of Health Bioscience, the University of Tokushima Graduate School
| | - Katsuya Tanaka
- Department of Anesthesiology, Institute of Health Bioscience, the University of Tokushima Graduate School
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