Bilateral ascending uterine arteries ligation for conservative management of complete placenta previa: three case reports
Placenta previa (PP) is considered one of the major causes of both antepartum and intrapartum bleeding, which necessitates preterm delivery typically by cesarean section. The optimal management is controversial. Surgical techniques to control severe bleeding after placental removal include uterine/i...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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IMR Press
2020-02-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/CEOG/47/1/10.31083/j.ceog.2020.01.5109 |
| _version_ | 1811255156036075520 |
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| author | K. Relakis A. Pontikaki I. Kosmas S. Sifakis |
| author_facet | K. Relakis A. Pontikaki I. Kosmas S. Sifakis |
| author_sort | K. Relakis |
| collection | DOAJ |
| description | Placenta previa (PP) is considered one of the major causes of both antepartum and intrapartum bleeding, which necessitates preterm delivery typically by cesarean section. The optimal management is controversial. Surgical techniques to control severe bleeding after placental removal include uterine/internal iliac artery ligation, compression sutures, and embolization of pelvic vessels; however, cesarean hysterectomy remains the ultimate rescue procedure for uncontrolled maternal hemorrhage. The authors present a modified surgical technique of the uterine arteries ligation for successful management of complete PP. The method was effective and hysterectomy was avoided in all cases. Serious complications such as hypovolemic shock, disseminated intravascular coagulopathy, urinary tract injuries, febrile infections, and uterine necrosis were not recorded. Double bilateral ligation of the ascending uterine arteries before placental removal constitutes a prophylactic method that prevents postpartum hemorrhage and emergency obstetric hysterectomy. This method has an additional advantage as if it proves ineffective for hemorrhage control, the basic steps for cesarean hysterectomy would have been done. |
| first_indexed | 2024-04-12T17:19:29Z |
| format | Article |
| id | doaj.art-16d65b810d844a658a67ae846f01b8b7 |
| institution | Directory Open Access Journal |
| issn | 0390-6663 |
| language | English |
| last_indexed | 2024-04-12T17:19:29Z |
| publishDate | 2020-02-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj.art-16d65b810d844a658a67ae846f01b8b72022-12-22T03:23:31ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632020-02-0147114414610.31083/j.ceog.2020.01.5109S0390-6663(20)00223-7Bilateral ascending uterine arteries ligation for conservative management of complete placenta previa: three case reportsK. Relakis0A. Pontikaki1I. Kosmas2S. Sifakis3Department of Obstetrics & Gynecology, University Hospital of Heraklion, Crete, GreeceDepartment of Obstetrics & Gynecology, University Hospital of Heraklion, Crete, GreeceDepartment of Obstetrics & Gynecology, University Hospital of Heraklion, Crete, GreeceDepartment of Obstetrics & Gynecology, University Hospital of Heraklion, Crete, GreecePlacenta previa (PP) is considered one of the major causes of both antepartum and intrapartum bleeding, which necessitates preterm delivery typically by cesarean section. The optimal management is controversial. Surgical techniques to control severe bleeding after placental removal include uterine/internal iliac artery ligation, compression sutures, and embolization of pelvic vessels; however, cesarean hysterectomy remains the ultimate rescue procedure for uncontrolled maternal hemorrhage. The authors present a modified surgical technique of the uterine arteries ligation for successful management of complete PP. The method was effective and hysterectomy was avoided in all cases. Serious complications such as hypovolemic shock, disseminated intravascular coagulopathy, urinary tract injuries, febrile infections, and uterine necrosis were not recorded. Double bilateral ligation of the ascending uterine arteries before placental removal constitutes a prophylactic method that prevents postpartum hemorrhage and emergency obstetric hysterectomy. This method has an additional advantage as if it proves ineffective for hemorrhage control, the basic steps for cesarean hysterectomy would have been done.https://www.imrpress.com/journal/CEOG/47/1/10.31083/j.ceog.2020.01.5109placenta previacesarean sectionbilateral ligation of uterine arteries |
| spellingShingle | K. Relakis A. Pontikaki I. Kosmas S. Sifakis Bilateral ascending uterine arteries ligation for conservative management of complete placenta previa: three case reports Clinical and Experimental Obstetrics & Gynecology placenta previa cesarean section bilateral ligation of uterine arteries |
| title | Bilateral ascending uterine arteries ligation for conservative management of complete placenta previa: three case reports |
| title_full | Bilateral ascending uterine arteries ligation for conservative management of complete placenta previa: three case reports |
| title_fullStr | Bilateral ascending uterine arteries ligation for conservative management of complete placenta previa: three case reports |
| title_full_unstemmed | Bilateral ascending uterine arteries ligation for conservative management of complete placenta previa: three case reports |
| title_short | Bilateral ascending uterine arteries ligation for conservative management of complete placenta previa: three case reports |
| title_sort | bilateral ascending uterine arteries ligation for conservative management of complete placenta previa three case reports |
| topic | placenta previa cesarean section bilateral ligation of uterine arteries |
| url | https://www.imrpress.com/journal/CEOG/47/1/10.31083/j.ceog.2020.01.5109 |
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