Use of ureteral catheter in uterine-sparing surgery for placenta accreta

Doğru, Şükran; Akkuş, Fatih; EREN, Gülnur; Acar, Ali

doi:10.2399/prn.22.0302009

Cited by 2 publications

(2 citation statements)

References 15 publications

(17 reference statements)

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“…We consider that the low rate of urinary tract injury in our study was due to the low rate of bladder invasion cases. Recent studies indicated that preoperative utilization of ureteral catheters in PAS cases does not reduce the risk of urinary system injury [ 37 , 38 ]. Accordingly, we did not perform double-J catheter insertion before laparotomy to avoid ureteral injury in this study.…”

Section: Discussionmentioning

confidence: 99%

A Novel Approach for Conservative Management of Placenta Accreta Spectrum Disorder Cases: Experience of a Single Surgeon

Yalınkaya,

Oğlak

2024

Journal of Pregnancy

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Background: This study is aimed at evaluating the conservative surgical treatment of patients with placenta accreta spectrum (PAS) disorder and at presenting the experience of a single surgeon.Materials and Methods: This retrospective study included 245 patients with placenta previa accompanied by PAS disorders operated at a university hospital between June 2013 and December 2023. The diagnosis of PAS was made by a single perinatologist using a combination of transvaginal and transabdominal ultrasonography. All patients were operated with conservative surgical technique by the same surgeon. The demographic and clinical characteristics of the patients, the anesthesia and incision types used, and the details of the surgical technique were evaluated.Results: Of the patients, 165 were operated on at the scheduled time, 80 were operated on under emergency conditions, and 232 (94.69%) of them were operated on under spinal anesthesia. All patients were operated on with a Pfannenstiel incision followed by a transverse incision to the upper border of the placenta to enter into the uterus. An average of 0.52 units of red blood cells per patient was transfused to all patients. Spontaneous intra‐abdominal bleeding developed in five patients, and surgical complications occurred in eight patients. No cesarean hysterectomy was performed, and no maternal mortality was detected in any of the cases. The mean time duration of surgery was 54.44 ± 11.37 (30–90) min, and the mean length of hospital stay was 1.71 ± 1.30 (1–9) days.Conclusions: We recommend this procedure as a novel technique and a robust and safe alternative to peripartum hysterectomy and other conservative surgical management procedures for cases with complete PP accompanied with PAS. This technique preserves the uterus as well as reduces blood loss, and transfusion requirement, and thus maternal morbidity and mortality in PAS cases.

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Section: Discussionmentioning

confidence: 99%

A Novel Approach for Conservative Management of Placenta Accreta Spectrum Disorder Cases: Experience of a Single Surgeon

Yalınkaya,

Oğlak

2024

Journal of Pregnancy

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“…Uterine-sparing surgery is performed by a multidisciplinary team in our clinic, and cesarean hysterectomy is performed in cases in which bleeding cannot be controlled as previously described for PAS [ 16 ]. After a preoperative evaluation by the urology team, we inserted a cystoscope-guided bilateral ureteral catheter in cases of suspected bladder or parametrium invasion (this not possible in some very urgent cases).…”

Section: Methodsmentioning

confidence: 99%

Fetal and maternal outcomes of segmental uterine resection in emergency and planned placenta percreta deliveries

Doğru,

Akkuş,

Atci

et al. 2024

Obstet Gynecol Sci

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Objective This study evaluated maternal and fetal outcomes of emergency uterine resection versus planned segmental uterine resection in patients with placenta percreta (PPC) and placenta previa (PP).Methods Patients with PP and PPC who underwent planned or emergency segmental uterine resection were included in this study. Demographic data, hemorrhagic morbidities, intra- and postoperative complications, length of hospital stay, surgical duration, and peri- and neonatal morbidities were compared.Results A total of 141 PPC and PP cases were included in this study. Twenty-five patients (17.73%) underwent emergency uterine resection, while 116 (82.27%) underwent planned segmental uterine resections. The postoperative hemoglobin changes, operation times, total blood transfusion, bladder injury, and length of hospital stay did not differ significantly between groups (P=0.7, P=0.6, P=0.9, P=0.9, and P=0.2, respectively). Fetal weights, 5-minute Apgar scores, and neonatal intensive care unit admission rates did not differ significantly between groups. The gestational age at delivery of patients presenting with bleeding was lower than that of patients who were admitted in active labor and underwent elective surgery (32 weeks [95% confidence interval [CI], 26-37] vs. 35 weeks [95% CI, 34-35]; P=0.037).Conclusion Using a multidisciplinary approach, this study performed at a tertiary center showed that maternal and fetal morbidity and mortality did not differ significantly between emergency versus planned segmental uterine resection.

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Use of ureteral catheter in uterine-sparing surgery for placenta accreta

Cited by 2 publications

References 15 publications

A Novel Approach for Conservative Management of Placenta Accreta Spectrum Disorder Cases: Experience of a Single Surgeon

A Novel Approach for Conservative Management of Placenta Accreta Spectrum Disorder Cases: Experience of a Single Surgeon

Fetal and maternal outcomes of segmental uterine resection in emergency and planned placenta percreta deliveries

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