Progressive Devascularization: A Novel Surgical Approach for Placenta Previa
Abstract Background The gold standard for antenatal diagnosis of placenta previa is the transvaginal ultrasonography. In placenta previa cases, separation of placental and uterine tissues is challenging even for the most experienced surgeons. Life-threatening obstetrical complications f...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical Publishers, Inc.
2018-10-01
|
| Series: | American Journal of Perinatology Reports |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1673373 |
| _version_ | 1819042170214023168 |
|---|---|
| author | Antonio F. Saad Nathan Kirsch George R. Saade Gary D. V. Hankins |
| author_facet | Antonio F. Saad Nathan Kirsch George R. Saade Gary D. V. Hankins |
| author_sort | Antonio F. Saad |
| collection | DOAJ |
| description | Abstract
Background The gold standard for antenatal diagnosis of placenta previa is the transvaginal ultrasonography. In placenta previa cases, separation of placental and uterine tissues is challenging even for the most experienced surgeons. Life-threatening obstetrical complications from cesarean deliveries with placenta previa include peripartum hemorrhage, coagulopathy, blood transfusion, peripartum hysterectomy, and multiple organ failure.
Cases We detailed the 3 cases of placenta previa that underwent bilateral uterine artery ligation; if hemostasis was not achieved, horizontal mattress sutures were placed in the lower uterine segment. All patients were discharged with minimal morbidity.
Conclusion For patients with placenta previa and low risk for placenta creta, counseling should include the risk for maternal morbidity and criteria for pursuing peripartum hysterectomy. Our devascularization, a stepwise surgical approach, shows promising outcomes in placenta previa cases.
Précis We propose a novel surgical approach, using a progressive devascularization surgical technique, for management of women with placenta previa, undergoing cesarean delivery. |
| first_indexed | 2024-12-21T09:36:38Z |
| format | Article |
| id | doaj.art-040108b47c7a4220bc984dd4e1254a2d |
| institution | Directory Open Access Journal |
| issn | 2157-6998 2157-7005 |
| language | English |
| last_indexed | 2024-12-21T09:36:38Z |
| publishDate | 2018-10-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | American Journal of Perinatology Reports |
| spelling | doaj.art-040108b47c7a4220bc984dd4e1254a2d2022-12-21T19:08:36ZengThieme Medical Publishers, Inc.American Journal of Perinatology Reports2157-69982157-70052018-10-010804e223e22610.1055/s-0038-1673373Progressive Devascularization: A Novel Surgical Approach for Placenta PreviaAntonio F. Saad0Nathan Kirsch1George R. Saade2Gary D. V. Hankins3Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TexasDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TexasDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TexasDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TexasAbstract Background The gold standard for antenatal diagnosis of placenta previa is the transvaginal ultrasonography. In placenta previa cases, separation of placental and uterine tissues is challenging even for the most experienced surgeons. Life-threatening obstetrical complications from cesarean deliveries with placenta previa include peripartum hemorrhage, coagulopathy, blood transfusion, peripartum hysterectomy, and multiple organ failure. Cases We detailed the 3 cases of placenta previa that underwent bilateral uterine artery ligation; if hemostasis was not achieved, horizontal mattress sutures were placed in the lower uterine segment. All patients were discharged with minimal morbidity. Conclusion For patients with placenta previa and low risk for placenta creta, counseling should include the risk for maternal morbidity and criteria for pursuing peripartum hysterectomy. Our devascularization, a stepwise surgical approach, shows promising outcomes in placenta previa cases. Précis We propose a novel surgical approach, using a progressive devascularization surgical technique, for management of women with placenta previa, undergoing cesarean delivery.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1673373previadevascularisationhemorrhagecesarean |
| spellingShingle | Antonio F. Saad Nathan Kirsch George R. Saade Gary D. V. Hankins Progressive Devascularization: A Novel Surgical Approach for Placenta Previa American Journal of Perinatology Reports previa devascularisation hemorrhage cesarean |
| title | Progressive Devascularization: A Novel Surgical Approach for Placenta Previa |
| title_full | Progressive Devascularization: A Novel Surgical Approach for Placenta Previa |
| title_fullStr | Progressive Devascularization: A Novel Surgical Approach for Placenta Previa |
| title_full_unstemmed | Progressive Devascularization: A Novel Surgical Approach for Placenta Previa |
| title_short | Progressive Devascularization: A Novel Surgical Approach for Placenta Previa |
| title_sort | progressive devascularization a novel surgical approach for placenta previa |
| topic | previa devascularisation hemorrhage cesarean |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1673373 |
| work_keys_str_mv | AT antoniofsaad progressivedevascularizationanovelsurgicalapproachforplacentaprevia AT nathankirsch progressivedevascularizationanovelsurgicalapproachforplacentaprevia AT georgersaade progressivedevascularizationanovelsurgicalapproachforplacentaprevia AT garydvhankins progressivedevascularizationanovelsurgicalapproachforplacentaprevia |