Caesarean section in cases of placenta praevia and accreta

Transecting versus avoiding incision of the anterior placenta previa during cesarean delivery

“…Cesarean delivery among women with anterior placenta previa can lead to substantial maternal and fetal blood loss if the placenta is incised during delivery [5,6]. The best technique for cesarean delivery among women with anterior placenta previa is not well described and might be either quick transection of the placenta or avoiding incision of the placenta altogether [6].…”

Re: Caesarean hysterectomy for placenta praevia/accreta using an approach via the pouch of Douglas

“…Thrombosis in the vessels may remain in situ, allowing for the identification of remaining individual bleeding sites for ligation. 4 …”

“…The author should be able to demonstrate that in his experience this technique reduces maternal morbidity (bleeding and bladder lesions), compared with traditional hysterectomy or previously published conservative techniques. 4 We hope that obstetricians think deeply about this technique before using it, mainly to understand that is not an easy solution for abnormal placentation cases, and also that Dr Matsuzaki be recognised as the original author of this approach. & In our technique, the posterior vaginal fornix at the pouch of Douglas is exposed by the placement of a sponge stick into the vagina.…”

“…In the future, assessment of functional microcirculatory haemodynamics with small handheld cameras, might assist in optimising fluid therapy. 4 The main two mechanisms behind oxygen delivery from red blood cells (RBC) Although Matsuzaki's is the first published description, this procedure was used by specialists before that. This method is especially performed when hysterectomy is indicated, and the invaded area between the bladder and the uterus is strongly attached to the bladder in the presence of exuberant neo circulation.…”

Conservative Treatment of a Placenta Accreta Case: Partial Segmental Uterine Resection

“…PA and its varieties produce damage of the invaded tissues (uterus and others) by developing new vascularization and pelvic anatomic distortion. These problems can be solved in different ways, and have led to the development of new techniques (6). The conservative method was first described by Arulkumaran et al (7).…”