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Introduction: The incidence of cesarean section has increased significantly in recent years. The study is retrospective and observational, over a period of 5 years (From April 2017 to April 2022). The present paper aims to show the correlation between the dehiscence of the hysteroraphic tranche, with anemia, the postoperative hematoma or the dehiscence of the skin wound in the postoperative period. Working method: This study was performed on a group of 5562 patients who gave birth by caesarean section, and found 4 patients who met the inclusion criteria. The inclusion criteria were secondary anemia, subaponevrotic haematoma or cutaneous wound dehiscence, associated with uterine dehiscence, followed by hysterectomy. Results: Patients with uterine wound dehiscence had subaponevrotic hematoma in all cases (100%) and only one patient had an association between a supraaponevrotic hematoma and a subaponevrotic hematoma (11%). From the perspective of cutaneous wound dehiscence, of the nine patients included in the study, only one patient (11%) presented wound dehiscence after hysterectomy. This patient did not need suturing of the wound, being treated conservatively. Conclusions: Out of the studied group of 5562 patients, 16 patients developed subaponevrotic haematomas, 4 of them developing uterine histeroraphy dehiscence and requiring a hysterectomy, with an incidence of 25%.
Introduction: The incidence of cesarean section has increased significantly in recent years. The study is retrospective and observational, over a period of 5 years (From April 2017 to April 2022). The present paper aims to show the correlation between the dehiscence of the hysteroraphic tranche, with anemia, the postoperative hematoma or the dehiscence of the skin wound in the postoperative period. Working method: This study was performed on a group of 5562 patients who gave birth by caesarean section, and found 4 patients who met the inclusion criteria. The inclusion criteria were secondary anemia, subaponevrotic haematoma or cutaneous wound dehiscence, associated with uterine dehiscence, followed by hysterectomy. Results: Patients with uterine wound dehiscence had subaponevrotic hematoma in all cases (100%) and only one patient had an association between a supraaponevrotic hematoma and a subaponevrotic hematoma (11%). From the perspective of cutaneous wound dehiscence, of the nine patients included in the study, only one patient (11%) presented wound dehiscence after hysterectomy. This patient did not need suturing of the wound, being treated conservatively. Conclusions: Out of the studied group of 5562 patients, 16 patients developed subaponevrotic haematomas, 4 of them developing uterine histeroraphy dehiscence and requiring a hysterectomy, with an incidence of 25%.
Abnormal placentation is a noncommon but life-threatening obstetric condition that requires a multidisciplinary approach. It is a spectrum of disorders that seems to parallel the increasing rate of cesarean sections. Imaging findings have a crucial role in detecting this abnormality early in the pregnancy and subsequently guiding and alerting the surgeon. Between accreta and percreta, the difference is huge; thus, they are managed with a different degree of radicality. The surgeon tends to treat more radically cases of placenta percreta with cesarean hysterectomy and needs to have special expertise in pelvic surgery, inter alia, and gynecologic oncology. While extrapolation does not find its way in every case of abnormally invasive placenta, a new inspired technique from gynecologic oncology surgeries and adapted to percreta cases seems to be applied safely and effectively in all circumstances of percreta. Conservative treatment is also an alternative but is limited to selected cases of placenta accreta.
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