Surgery tactics for placenta increta with different depths of invasion

Shmakov, Shmakov R.G.; Pirogova, Pirogova M.M.; Vasilchenko, Vasilchenko O.N.; Chuprynin, Chuprynin V.D.; Ezhova, Ezhova L.S.

doi:10.18565/aig.2020.1.78-82

Cited by 6 publications

(1 citation statement)

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“…В данной статье представлен успешный клинический опыт осуществленного в Перинатальном центре г. Ноябрьска (ЯНАО) органосохраняющего хирургического лечения врастания плаценты, исключающий этап донного кесарева сечения. Он основан на возвращении к прежней методике кесарева сечения в нижнем сегменте матки с одновременной метропластикой и иссечением врастания плаценты, методике, от которой в настоящее время отказались в пользу донного кесарева сечения [17,18], в то время как проведенные операции демонстрируют оптимальный результат: сравнительно невысокую кровопотерю, небольшую продолжительность операции, а главное, более благоприятный прогноз при последующих репродуктивных планах.…”

Section: материалы и методыunclassified

Clinical Experience with Organ-Preserving Surgery in Placenta Accreta

Arutyunyants¹,

Ovchinnikova²

2022

Kreativnaâ hirurgiâ i onkologiâ

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Introduction. A higher number of repeated cesarean sections determine a higher risk of placental ingrowth into the scar area of the uterus. The absence of current clinical guidelines in this field necessitates the need for development of various methods for organ-preserving surgery in placenta accreta, which preserve a woman’s reproductive function, as well as reduce risks for future pregnancies and childbirth.Materials and methods. The paper presents the successful clinical experience of organ-preserving surgical treatment of placental ingrowth, excluding the stage of fundal cesarean section (Perinatal Center, Noyabrsk, Yamalo-Nenets Autonomous District).Case description. The paper describes two clinical cases of successful organ-preserving surgical treatment of placental ingrowth with preservation of reproductive function and provision of a more favorable prognosis for subsequent reproductive plans due to excluding formation of two scars on the uterus in different localizations.Results and discussion. Early dissection of adhesions in order to provide access to the surgical site is crucial and reduces the blood loss after fetal extraction and the risk of intraoperative complications such as bladder, ureteric and intestinal injury. Temporary compression hemostasis via performing endovascular temporary balloon occlusion of the infrarenal aorta, or via temporary turnstile hemostasis using a Foley catheter, allows for organpreserving surgery that excludes the formation of two scars on the uterus in different localizations without increasing the amount of blood loss.Conclusion. Surgical tactics in organ-preserving treatment of placental ingrowth excludes the stage of fundal cesarean section, and involves the cesarean section at the border of the uterine-placental hernia and the body of the uterus with subsequent metroplasty. The surgery performed demonstrate the optimal result – a relatively low blood loss, a short duration of the operation and, above all, more favorable prognosis for subsequent reproduction.

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Section: материалы и методыunclassified

Clinical Experience with Organ-Preserving Surgery in Placenta Accreta

Arutyunyants¹,

Ovchinnikova²

2022

Kreativnaâ hirurgiâ i onkologiâ

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Placenta previa and placenta accreta: questions of diagnosing and obstetric management

Syundyukova¹,

Chulanova²,

Сашенков³

et al. 2022

Ross. vestn. akush.-ginekol.

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Metroplasty in the delivery of pregnant women with a history of two cesarean sections

Tarasova,

Musin,

Yaschuk

et al. 2024

V.F.Snegirev Archives of Obstetrics and Gynecology

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The purpose of our study is to evaluate the effectiveness of metroplasty at the stage of abdominal delivery in women with a history of two cesarean section operationsMaterials and methods. From 2020 to 2022, 150 pregnant women were examined. The patients were divided into 3 groups: the first group - pregnant women with a history of cesarean section, the second group – pregnant women with two cesarean sections. In these groups, metroplasty was performed at the stage of delivery. The third control group consisted of pregnant women with a history of two cesarean sections who underwent surgical delivery without excision of scar tissue in the lower segment.Metroplasty was performed before fetal extraction with a whole fetal bladder in accordance with the patent "Method of metroplasty during operative delivery in women with two or more cesarean sections".In order to study the dynamics of changes in scar thickness, all women underwent ultrasound examination 2 hours later, on the third day after delivery, and 6 months after delivery.The results of the study. Resection of the scar area on the uterus during repeated cesarean section improves the residual thickness of the myometrium, which is determined by ultrasound 6 months after surgery. This technique allows you to form a functionally consistent scar on the uterus after two cesarean section operations.

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Surgery tactics for placenta increta with different depths of invasion

Cited by 6 publications

References 0 publications

Clinical Experience with Organ-Preserving Surgery in Placenta Accreta

Clinical Experience with Organ-Preserving Surgery in Placenta Accreta

Placenta previa and placenta accreta: questions of diagnosing and obstetric management

Metroplasty in the delivery of pregnant women with a history of two cesarean sections

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