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Özcan HÇ, Barut MB, Sucu S, Bademkiran MH, Tepe NB, Özcan ZÖ, Kazaz TG. Is temporary clamping of the bilateral common iliac artery beneficial in reducing intraoperative blood loss in patients with segmental resected anterior placenta percreta?: A prospective observational study. Int J Gynaecol Obstet 2024. [PMID: 38842245 DOI: 10.1002/ijgo.15720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/05/2024] [Accepted: 05/11/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE The aim of our study was to investigate whether temporary clamping of the bilateral common iliac artery (BCIA) has a role in reducing intraoperative blood loss in patients with segmentally resected anterior placenta percreta or not. METHODS This prospective observational study included patients with anterior placenta percreta who underwent cesarean segmental resection either with BCIA temporary clamping or without clamping between October 2022 and September 2023. RESULTS A comparison of demographic, obstetric, and surgical parameters and the need for transfusion (except for postoperative erythrocyte suspension transfusion) between the two groups revealed no significant difference (P > 0.05). In contrast, the amount of intraoperative blood loss (P = 0.001) (1974 ± 749 mL vs 2702 ± 615 mL) and postoperative erythrocyte suspension transfusion (P = 0.046) in patients who underwent BCIA temporary clamping were significantly lower than in those who did not undergo BCIA temporary clamping. CONCLUSION Temporary clamping of BCIA plays a significant favorable role both in reducing blood loss and the need for postoperative transfusion in patients with placenta percreta who underwent segmental uterine resection.
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Affiliation(s)
- Hüseyin Çağlayan Özcan
- Department of Obstetrics and Gynecology, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | | | - Seyhun Sucu
- Department of Obstetrics and Gynecology, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | | | - Neslihan Bayramoğlu Tepe
- Department of Obstetrics and Gynecology, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Zeynep Özer Özcan
- Department of Ophthalmology, Gaziantep State Hospital, Gaziantep, Turkey
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2
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Li GT, Liu YJ, Li XF. Anatomical retracting suture to stop postpartum hemorrhage from the lower uterine segment. Asian J Surg 2023; 46:594-595. [PMID: 35842389 DOI: 10.1016/j.asjsur.2022.06.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 06/30/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
- Guang-Tai Li
- Department of Obstetrics and Gynecology, Hebei Yanda Hospital, Langfang, Hebei Province, 065201, PR China.
| | - Ya-Jing Liu
- Department of Obstetrics and Gynecology, China Emergency General Hospital (China Meitan General Hospital), No. 29 Xibahe Nanli, Chaoyang District, Beijing, 100028, PR China
| | - Xiao-Fan Li
- Departments of Radiation Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, 52 Fucheng Rd, Haidian District, Beijing, 100142, PR China
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3
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Arresting post-partum hemorrhage using the novel trans-vaginal uterine artery clamp. Eur J Obstet Gynecol Reprod Biol 2022; 272:6-15. [PMID: 35276445 DOI: 10.1016/j.ejogrb.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/28/2022] [Accepted: 03/01/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Post-partum hemorrhage (PPH) continues to be the leading cause of maternal mortality in low-resource settings. The commonest variant - Atonic PPH, is managed by additional pharmacological measures which may fail. Additional surgical interventions for hemostasis take time and are not universally available. Immediate arrest of bleeding was deemed essential and a novel Transvaginal Uterine Artery Clamp (TVUAC) was explored for its effectiveness in achieving immediate hemostasis in atonic and mixed post-partum hemorrhage. STUDY DESIGN A retrospective chart review was performed for all patients, who underwent vaginal delivery and developed immediate post-partum atonic PPH, in a tertiary care center in South India, between 1st April 2015 and 31st December 2020. As soon as excess bleeding was observed, two TVUACs were applied trans-vaginally at 3' and 9'o clock position of the cervix to occlude the uterine arteries where it joins the isthmus of the uterus. RESULTS Of 3999 vaginal deliveries, there were 251 patients who developed primary atonic PPH during the study period, of which 89 were managed by medical measures alone. Out of the remaining 162 patients, in 153 (94.4%) TVUAC helped to achieve hemostasis; with TVUAC alone in 120 patients (78.43%) and with an additional second line surgical intervention in 33 patients. In nine patients, TVUAC was not readily available and hence second line interventions alone were used. None required any third line surgical interventions (laparotomies) for hemostasis nor were there any incident of maternal mortality or consumptive coagulopathy. TVUAC was applied for a mean duration of 25 ± 10 min. Only 11.6% (29/251, 95% C.I 7.9-16.1%) of the patients required a blood transfusion with a median of 2 (1-4) units of packed RBC. No procedure related complications were reported up to a scheduled 6th week in-person follow-up. CONCLUSION The novel TVUAC shows potential in limiting third line interventions, maternal morbidity and mortality. Its effectiveness and safety may be further explored as a first line surgical adjunct to medical measures, in PPH protocols in low-resource settings.
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Alalfy M, Hussein E, Saber W, Elsharkawy M, Salama S, Lasheen Y, Elshafey D, Taher A, Farouk D, Eltaieb E, Elsirgany S, Hussein M, Fikry M, Hassan H, Sadek J, Alaa D, Torad H, Abdella R, Ali S, Yehia A, Lotfy R, Hanafy A, Hassan A. Alalfy modified cervical inversion technique as a tamponade in controlling PPH in placenta previa, a multicentric double blind randomized controlled trial. J Matern Fetal Neonatal Med 2019; 34:3162-3168. [PMID: 31630600 DOI: 10.1080/14767058.2019.1678140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Postpartum hemorrhage that occurs frequently with placenta previa is one of the causes of maternal mortality in 14% in developing countries. OBJECTIVE To assess efficacy of cervical inversion as a tamponade in controlling bed of placenta in cases of placenta previa. PATIENTS AND METHOD A prospective randomized controlled study was conducted among a total of 240 pregnant women with placenta previa (120 subjected to Alalfy modified cervical inversion technique plus hemostatic sutures and 120 was not subjected cervical inversion and only was subjected to hemostatic sutures in Obstetrics and Gynecology Department at Suez Canal University hospital, Helwan University and Algezeerah hospital for a planned cesarean section). RESULTS The mean intraoperative blood loss, the intraoperative time, and the postoperative hemoglobin show a statistically significant difference between cases with placenta previa who were exposed to cervical inversion in comparison to cases that had no cervical inversion with a p-value <.001. CONCLUSION Modified cervical inversion (Alalfy technique) as a tamponade when added to hemostatic sutures to the placental bed is an easy, rapid, and efficient procedure that can decrease the amount of blood loss, time needed to stop bleeding per bed, total operative time, also it can decrease the need for blood transfusion.
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Affiliation(s)
- Mahmoud Alalfy
- Reproductive Health and Family Planning Department, National Research Centre, Giza, Egypt.,Department of Obstetrics and Gynecology, Algezeerah Hospital, Giza, Egypt
| | - Elham Hussein
- Obstetrics and Gynecology Department, Suez Canal University, Al Ismailia, Egypt
| | - Waled Saber
- Obstetrics and Gynecology Department, Kasr alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Elsharkawy
- Obstetrics and Gynecology Department, Kasr alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sameh Salama
- Reproductive Health and Family Planning Department, National Research Centre, Giza, Egypt.,Department of Obstetrics and Gynecology, Algezeerah Hospital, Giza, Egypt
| | - Yossra Lasheen
- Obstetrics and Gynecology Department, Kasr alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Doaa Elshafey
- Obstetrics and Gynecology Department, Kasr alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ayman Taher
- Obstetrics and Gynecology Department, Kasr alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dalia Farouk
- Obstetrics and Gynecology Department, Kasr alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - E Eltaieb
- Obstetrics and Gynecology Department, Ainshams Faculty of Medicine, Cairo, Egypt
| | - Sherif Elsirgany
- Reproductive Health and Family Planning Department, National Research Centre, Giza, Egypt.,Department of Obstetrics and Gynecology, Algezeerah Hospital, Giza, Egypt
| | - Mohamed Hussein
- Obstetrics and Gynecology Department, Kasr alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Fikry
- Obstetrics and Gynecology Department, Kasr alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hatem Hassan
- Reproductive Health and Family Planning Department, National Research Centre, Giza, Egypt.,Department of Obstetrics and Gynecology, Algezeerah Hospital, Giza, Egypt
| | - Jehan Sadek
- Obstetrics and Gynecology Department, Kasr alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Doaa Alaa
- Obstetrics and Gynecology Department, Kasr alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hesham Torad
- Urology Department, Kasralainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rana Abdella
- Obstetrics and Gynecology Department, Kasr alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sief Ali
- Obstetrics and Gynecology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Amera Yehia
- Obstetrics and Gynecology Department, Kasr alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rehab Lotfy
- Obstetrics and Gynecology Department, Kasr alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amal Hanafy
- Obstetrics and Gynecology Department, Kasr alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Hassan
- Obstetrics and Gynecology Department, Helwan Faculty of Medicine, Helwan University, Helwan, Egypt
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5
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Karaçor T, Bülbül M, Nacar MC, Kirici P, Peker N, Sak S, Sak ME. The parameters affecting the success of uterus-sparing surgery in cases of placenta adhesion spectrum disorder. J Matern Fetal Neonatal Med 2019; 34:1091-1098. [PMID: 31177877 DOI: 10.1080/14767058.2019.1624719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study aimed to evaluate the parameters affecting the treatment success of conservative surgery in cases with placental invasion anomaly. METHODS Archive files and digital image records of 67 patients with placental invasion anomaly were studied. The patients were divided into two groups, a conservative surgery group and a cesarean hysterectomy group. Demographic data, cervical length, placental localization, placental surface area adhering to previous cesarean section line, preoperative and postoperative hematocrit values, transfused blood products, and surgical complications were compared between the two groups. RESULTS In the conservative surgery group, the cervical length was longer (p < .001) and the surface area of the placenta in the previous cesarean scar line was smaller (p < .001). For cervical length, the sensitivity and specificity values were 97 and 81%, respectively, when the cut-off value was 35.5 mm. When the cut-off value for the placental surface area in the previous cesarean scar line was 85.5 cm2, the sensitivity and specificity values were 68 and 72%, respectively. In the caesarean hysterectomy group, the preoperative and postoperative hematocrit values were lower (p < .001, p = .003, respectively), and the amount of transfused erythrocyte suspension and fresh frozen plasma were higher (p < .001, p = .001, respectively). CONCLUSION In this study, it was concluded that the presence of the nondestructive intact cervical tissue, in the cases with placental invasion anomaly and/or the small size of the placental surface area adhering to the previous cesarean scar line, increase the feasibility of conservative surgery.
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Affiliation(s)
- Talip Karaçor
- Department of Obstetrics and Gynecology, Adıyaman University School of Medicine, Adıyaman, Turkey
| | - Mehmet Bülbül
- Department of Obstetrics and Gynecology, Adıyaman University School of Medicine, Adıyaman, Turkey
| | - Mehmet Can Nacar
- Department of Obstetrics and Gynecology, Adıyaman University School of Medicine, Adıyaman, Turkey
| | - Pınar Kirici
- Department of Obstetrics and Gynecology, Adıyaman University School of Medicine, Adıyaman, Turkey
| | - Nurullah Peker
- Department of Obstetrics and Gynecology, Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey
| | - Sibel Sak
- Department of Obstetrics and Gynecology, Harran University School of Medicine, Şanlıurfa, Turkey
| | - Muhammet Erdal Sak
- Department of Obstetrics and Gynecology, Harran University School of Medicine, Şanlıurfa, Turkey
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Nieto-Calvache AJ, Zambrano MA, Herrera NA, Usma A, Bryon AM, Benavides Calvache JP, López L, Mejía M, Palacios-Jaraquemada JM. Resective-reconstructive treatment of abnormally invasive placenta: Inter Institutional Collaboration by telemedicine (eHealth). J Matern Fetal Neonatal Med 2019; 34:765-773. [PMID: 31057039 DOI: 10.1080/14767058.2019.1615877] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Resective-reconstructive treatment of an abnormally invasive placenta, also known as conservative surgical management, allows a comprehensive treatment of the pathology in only one surgery; however, this alternative is not generally included in international consensus, as it requires specific training. Here, we report our experience of this type of treatment and its plausibility after training facilitated by interinstitutional collaboration via telemedicine.Materials and methods: A total of 48 women who were diagnosed with abnormally invasive placenta, before and after changes due to the resection-reconstruction protocol were included in the study.Results: In total, 14 conservative reconstructive procedures were performed with outcomes of a lower rate of bleeding, reduced transfusions and complications, and a shorter duration of hospitalization than women with hysterectomy.Conclusion: Conservative surgical management is a safe alternative when implemented at specialized centers by trained groups of professionals. Interinstitutional collaboration, using appropriate telemedicine is a safe and effective alternative to enable training in resective-conservative management of abnormally invasive placenta.
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Affiliation(s)
- Albaro J Nieto-Calvache
- Abnormally Invasive Placenta Unit, Department of Obstetrics and Gynecology, Fundación Valle del Lili. Cali, Colombia.,Facultad de Ciencias de la Salud, Universidad Icesi. Cali, Colombia
| | - Maria A Zambrano
- Centro de Investigaciones Clínicas, Fundación Valle del Lili. Cali, Colombia
| | | | - Ana Usma
- Facultad de Ciencias de la Salud, Universidad Icesi. Cali, Colombia
| | - A Messa Bryon
- Abnormally Invasive Placenta Unit, Department of Obstetrics and Gynecology, Fundación Valle del Lili. Cali, Colombia.,Facultad de Ciencias de la Salud, Universidad Icesi. Cali, Colombia
| | - Juan P Benavides Calvache
- Abnormally Invasive Placenta Unit, Department of Obstetrics and Gynecology, Fundación Valle del Lili. Cali, Colombia.,Facultad de Ciencias de la Salud, Universidad Icesi. Cali, Colombia
| | - Leidy López
- Abnormally Invasive Placenta Unit, Department of Obstetrics and Gynecology, Fundación Valle del Lili. Cali, Colombia
| | - Mauricio Mejía
- Abnormally Invasive Placenta Unit, Department of Obstetrics and Gynecology, Fundación Valle del Lili. Cali, Colombia
| | - Jose M Palacios-Jaraquemada
- Centre for Medical Education and Clinical Research (CEMIC), Department of Gynecology and Obstetrics, Buenos Aires, Argentina
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7
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El Gelany S, Ibrahim EM, Mohammed M, Abdelraheim AR, Khalifa EM, Abdelhakium AK, Yousef AM, Hassan H, Goma K, Khairy M. Management of bleeding from morbidly adherent placenta during elective repeat caesarean section: retrospective -record -based study. BMC Pregnancy Childbirth 2019; 19:106. [PMID: 30922265 PMCID: PMC6439998 DOI: 10.1186/s12884-019-2244-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 03/13/2019] [Indexed: 12/05/2022] Open
Abstract
Background Controlling massive haemorrhage from morbidly adherent placenta (MAP) at caesarean section is a major surgical challenge to obstetricians. This study compares different intra-operative interventions to control haemorrhage from morbidly adherent placenta and its impact on maternal morbidity. Methods Retrospective analysis was done for baseline characteristics, intra-operative and postoperative complications of 125 patients with morbidly adherent placenta who had elective CS at 35–38 weeks gestation in the period from 01/2012 to 01/2017. The included patients were categorized into three groups according to intra-operative interventions they had for controlling bleeding; Group A (n = 42) had only balloon tamponade, Group B (n = 40) had balloon tamponade and bilateral uterine artery ligation, in Group C (n = 43) all cases were managed by bilateral uterine artery ligation and inverting the cervix into the uterine cavity and suturing the anterior and/or the posterior cervical lips into the anterior and/or posterior walls of the lower uterine segment using the cervix as a natural tamponade. Results There were no differences of baseline characteristics of patients in all groups. Group C had significantly better outcomes as compared with groups A and B; less total blood loss (Group C 2869.5 ml vs Group B 4580 ml, Group A 4812 ml, P < 0.001), less requirement of blood transfusion more than 4 units (Group C 4/43, Group B 10/40,Group A 12/42, P < 0.02), significant reduction in prolonged hospital stay over 10 days (Group C 2/43, Group B 9/40,Group A 14/42, P < 0.001) and lower risk of coagulopathy (Group C 4/43, B 8/40, A 9/42), visceral injuries (Group C 4/43 vs B 8/40, A 10/42,P < 0.01) and need for hysterectomy (Group C 4/43 vs B 11/40, A 13/42,P < 0.001). Conclusion A combination bilateral uterine artery ligation and using the cervix as a natural tamponade are very effective and simple methods in controlling bleeding resulting from separated placenta accreta. Trial registration The findings are part of the research project registered in ClinicalTrials.gov NCT02590484. Registered 28 October 2015. Electronic supplementary material The online version of this article (10.1186/s12884-019-2244-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Saad El Gelany
- Obstetrics and Gynecology Department, Faculty of Medicine, Minia Maternity and Children University Hospital, Minia University, Elsalam, Eloboor, Maghaghaga City, Minya, Egypt.
| | - Emad M Ibrahim
- Obstetrics and Gynecology Department, Faculty of Medicine, Minia Maternity and Children University Hospital, Minia University, Elsalam, Eloboor, Maghaghaga City, Minya, Egypt
| | - Mo'men Mohammed
- Obstetrics and Gynecology Department, Faculty of Medicine, Minia Maternity and Children University Hospital, Minia University, Elsalam, Eloboor, Maghaghaga City, Minya, Egypt
| | - Ahmed R Abdelraheim
- Obstetrics and Gynecology Department, Faculty of Medicine, Minia Maternity and Children University Hospital, Minia University, Elsalam, Eloboor, Maghaghaga City, Minya, Egypt
| | - Eissa M Khalifa
- Obstetrics and Gynecology Department, Faculty of Medicine, Minia Maternity and Children University Hospital, Minia University, Elsalam, Eloboor, Maghaghaga City, Minya, Egypt
| | - Ahmed K Abdelhakium
- Obstetrics and Gynecology Department, Faculty of Medicine, Minia Maternity and Children University Hospital, Minia University, Elsalam, Eloboor, Maghaghaga City, Minya, Egypt
| | - Ayman M Yousef
- Obstetrics and Gynecology Department, Faculty of Medicine, Minia Maternity and Children University Hospital, Minia University, Elsalam, Eloboor, Maghaghaga City, Minya, Egypt
| | - Heba Hassan
- Obstetrics and Gynecology Department, Faculty of Medicine, Minia Maternity and Children University Hospital, Minia University, Elsalam, Eloboor, Maghaghaga City, Minya, Egypt
| | - Khaled Goma
- Obstetrics and Gynecology Department, Faculty of Medicine, Minia Maternity and Children University Hospital, Minia University, Elsalam, Eloboor, Maghaghaga City, Minya, Egypt
| | - Mohammed Khairy
- Obstetrics and Gynecology Department, Faculty of Medicine, Minia Maternity and Children University Hospital, Minia University, Elsalam, Eloboor, Maghaghaga City, Minya, Egypt
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8
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Hussein AM, Kamel A, Raslan A, Dakhly DMR, Abdelhafeez A, Nabil M, Momtaz M. Modified cesarean hysterectomy technique for management of cases of placenta increta and percreta at a tertiary referral hospital in Egypt. Arch Gynecol Obstet 2019; 299:695-702. [PMID: 30607590 DOI: 10.1007/s00404-018-5027-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 12/14/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To evaluate the effect of a modified type II radical hysterectomy on maternal morbidities and mortality in cases with abnormally invasive placenta (AIP). METHODS 63 cases with AIP were managed at one of the largest referral centers in Egypt in a prospective study design. This technique entails devascularization of the uterus laterally on both sides and to clamp the uterus at the lowest possible point just below the level of the placenta while sparing the ureters. RESULTS The difference between pre- and post-operative hemoglobin was only about 1 gm/dl, and the mean blood loss was 1673 ± 958 ml. There was a significant drop in the post-operative need for blood and blood product replacement, packed red blood cells (p = 0.013), fresh red blood cells (p < 0.001), and plasma units (p = 0.012). Operative time (skin to skin) averaged 190 ± 58.2 min as the technique is slow and utilizes meticulous hemostatic steps. ICU admission was 4.8% with a mean total hospital stay of 8.6 ± 3.6 days. Histopathological examination revealed 58 cases of placenta increta and five percreta cases. We also had 16 bladder injuries (25.4%) and two ureteric injuries, and no maternal mortalities. CONCLUSION This technique reduces maternal morbidity and mortality while performing cesarean hysterectomy for cases with AIP.
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Affiliation(s)
- Ahmed M Hussein
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Ahmed Kamel
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Giza, Egypt.
| | - Ayman Raslan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Dina M R Dakhly
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Ali Abdelhafeez
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mohamed Nabil
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mohamed Momtaz
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Giza, Egypt
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9
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Takahashi H, Ohkuchi A, Usui R, Suzuki H, Baba Y, Matsubara S. Matsubara-Takahashi cervix-holding technique for massive postpartum hemorrhage in patients with placenta previa with or without placenta accreta spectrum disorders. Int J Gynaecol Obstet 2017; 140:357-364. [DOI: 10.1002/ijgo.12390] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/12/2017] [Accepted: 11/15/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Hironori Takahashi
- Department of Obstetrics and Gynecology; Jichi Medical University; Shimotsuke Tochigi Japan
| | - Akihide Ohkuchi
- Department of Obstetrics and Gynecology; Jichi Medical University; Shimotsuke Tochigi Japan
| | - Rie Usui
- Department of Obstetrics and Gynecology; Jichi Medical University; Shimotsuke Tochigi Japan
| | - Hirotada Suzuki
- Department of Obstetrics and Gynecology; Jichi Medical University; Shimotsuke Tochigi Japan
| | - Yosuke Baba
- Department of Obstetrics and Gynecology; Jichi Medical University; Shimotsuke Tochigi Japan
| | - Shigeki Matsubara
- Department of Obstetrics and Gynecology; Jichi Medical University; Shimotsuke Tochigi Japan
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10
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Meng JL, Gong WY, Wang S, Ni XJ, Zuo CT, Gu YZ. Two-tourniquet sequential blocking as a simple intervention for hemorrhage during cesarean delivery for placenta previa accreta. Int J Gynaecol Obstet 2017; 138:361-362. [PMID: 28475239 DOI: 10.1002/ijgo.12199] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 03/05/2017] [Accepted: 05/02/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Jin-Lai Meng
- Department of Obstetrics and Gynecology; Shandong Provincial Hospital Affiliated to Shandong University; Jinan Shandong China
| | - Wei-Yan Gong
- Department of Obstetrics and Gynecology; Shandong Provincial Hospital Affiliated to Shandong University; Jinan Shandong China
| | - Shan Wang
- Department of Obstetrics and Gynecology; Shandong Provincial Hospital Affiliated to Shandong University; Jinan Shandong China
| | - Xiao-Jing Ni
- Department of Obstetrics and Gynecology; Shandong Provincial Hospital Affiliated to Shandong University; Jinan Shandong China
| | - Chang-Ting Zuo
- Department of Obstetrics and Gynecology; Shandong Provincial Hospital Affiliated to Shandong University; Jinan Shandong China
| | - Yong-Zhong Gu
- Department of Obstetrics and Gynecology; Shandong Provincial Hospital Affiliated to Shandong University; Jinan Shandong China
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11
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Kilicci C, Sanverdi I, Ozkaya E, Eser A, Bostanci E, Yayla Abide C, Yenidede I. Segmental resection of anterior uterine wall in cases with placenta percreta: a modified technique for fertility preserving approach. J Matern Fetal Neonatal Med 2017; 31:1198-1203. [DOI: 10.1080/14767058.2017.1311862] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Cetin Kilicci
- Department of Obstetrics and Gynaecology, Zeynep Kamil Women and Children’s Health Training and Research Hospital, Istanbul, Turkey
| | - Ilhan Sanverdi
- Department of Obstetrics and Gynaecology, Zeynep Kamil Women and Children’s Health Training and Research Hospital, Istanbul, Turkey
| | - Enis Ozkaya
- Department of Obstetrics and Gynaecology, Zeynep Kamil Women and Children’s Health Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Eser
- Department of Obstetrics and Gynaecology, Zeynep Kamil Women and Children’s Health Training and Research Hospital, Istanbul, Turkey
| | - Evrim Bostanci
- Department of Obstetrics and Gynaecology, Zeynep Kamil Women and Children’s Health Training and Research Hospital, Istanbul, Turkey
| | - Cigdem Yayla Abide
- Department of Obstetrics and Gynaecology, Zeynep Kamil Women and Children’s Health Training and Research Hospital, Istanbul, Turkey
| | - Ilter Yenidede
- Department of Obstetrics and Gynaecology, Zeynep Kamil Women and Children’s Health Training and Research Hospital, Istanbul, Turkey
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Karaman E, Kolusarı A, Çetin O, Çim N, Alkış İ, Yıldızhan R, Şahin HG, Gül A. Local resection may be a strong alternative to cesarean hysterectomy in conservative surgical management of placenta percreta: experiences from a tertiary hospital. J Matern Fetal Neonatal Med 2016; 30:947-952. [DOI: 10.1080/14767058.2016.1192119] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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On-site hemostatic suturing for placenta previa: concerns and clarifications. Arch Gynecol Obstet 2015; 293:223-224. [PMID: 26559419 DOI: 10.1007/s00404-015-3959-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 11/03/2015] [Indexed: 10/22/2022]
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El Gelany SAA, Abdelraheim AR, Mohammed MM, Gad El-Rab MT, Yousef AM, Ibrahim EM, Khalifa EM. The cervix as a natural tamponade in postpartum hemorrhage caused by placenta previa and placenta previa accreta: a prospective study. BMC Pregnancy Childbirth 2015; 15:295. [PMID: 26559634 PMCID: PMC4642648 DOI: 10.1186/s12884-015-0731-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 11/04/2015] [Indexed: 11/30/2022] Open
Abstract
Background Placenta previa and placenta accreta carry significant maternal and fetal morbidity and mortality. Several techniques have been described in the literature for controlling massive bleeding associated with placenta previa cesarean sections. The objective of this study was to evaluate the efficacy and safety of the use of the cervix as a natural tamponade in controlling postpartum hemorrhage caused by placenta previa and placenta previa accreta. Methods This prospective study was conducted on 40 pregnant women admitted to our hospital between June 2012 and November 2014. All participating women had one or more previous cesarean deliveries and were diagnosed with placenta previa and/or placenta previa accreta. Significant bleeding from the placental bed during cesarean section was managed by inverting the cervix into the uterine cavity and suturing the anterior and/or the posterior cervical lips into the anterior and/or posterior walls of the lower uterine segment. Results The technique of cervical inversion described above was successful in stopping the bleeding in 38 out of 40 patients; yielding a success rate of 95 %. We resorted to hysterectomy in only two cases (5 %). The mean intra-operative blood loss was 1572.5 mL, and the mean number of blood units transfused was 3.1. The mean time needed to perform the technique was 5.4 ± 0.6 min. The complications encountered were as follows: bladder injury in the two patients who underwent hysterectomy and wound infection in one patient. Postoperative fever that responded to antibiotics occurred in 1 patient. The mean duration of the postoperative hospital stay was 3.5 days Conclusions This technique of using the cervix as a natural tamponade appears to be safe, simple, time-saving and potentially effective method for controlling the severe postpartum hemorrhage (PPH) caused by placenta previa/placenta previa accreta. This technique deserves to be one of the tools in the hands of obstetricians who face the life-threatening hemorrhage of placenta accreta. Trial registration ClinicalTrials.gov NCT02590484. Registered 28 October 2015 Electronic supplementary material The online version of this article (doi:10.1186/s12884-015-0731-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Saad A A El Gelany
- Minia Maternity & Children University Hospital, Department of Obstetrics & Gynecology, Faculty of Medicine, Minia University, Minia, Egypt.
| | - Ahmed R Abdelraheim
- Minia Maternity & Children University Hospital, Department of Obstetrics & Gynecology, Faculty of Medicine, Minia University, Minia, Egypt.
| | - Mo'men M Mohammed
- Minia Maternity & Children University Hospital, Department of Obstetrics & Gynecology, Faculty of Medicine, Minia University, Minia, Egypt.
| | - Mohammed T Gad El-Rab
- Minia Maternity & Children University Hospital, Department of Obstetrics & Gynecology, Faculty of Medicine, Minia University, Minia, Egypt.
| | - Ayman M Yousef
- Minia Maternity & Children University Hospital, Department of Obstetrics & Gynecology, Faculty of Medicine, Minia University, Minia, Egypt.
| | - Emad M Ibrahim
- Minia Maternity & Children University Hospital, Department of Obstetrics & Gynecology, Faculty of Medicine, Minia University, Minia, Egypt.
| | - Eissa M Khalifa
- Minia Maternity & Children University Hospital, Department of Obstetrics & Gynecology, Faculty of Medicine, Minia University, Minia, Egypt.
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