Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study
Abstract Background Placenta accreta spectrum (PAS) cesarean hysterectomy is performed under conditions of shock and can result in serious complications. This study aimed to evaluate the usefulness of the “Holding-up uterus” surgical technique with a shock index (S.I.) > 1.5. Methods Twelve patie...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-024-02311-8 |
| _version_ | 1827382460637249536 |
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| author | Jin Takahashi Makoto Orisaka Daisuke Inoue Hiroshi Kawamura Nozomu Takahashi Hideaki Tsuyoshi Akiko Shinagawa Tetsuji Kurokawa Yoshio Yoshida |
| author_facet | Jin Takahashi Makoto Orisaka Daisuke Inoue Hiroshi Kawamura Nozomu Takahashi Hideaki Tsuyoshi Akiko Shinagawa Tetsuji Kurokawa Yoshio Yoshida |
| author_sort | Jin Takahashi |
| collection | DOAJ |
| description | Abstract Background Placenta accreta spectrum (PAS) cesarean hysterectomy is performed under conditions of shock and can result in serious complications. This study aimed to evaluate the usefulness of the “Holding-up uterus” surgical technique with a shock index (S.I.) > 1.5. Methods Twelve patients who underwent PAS cesarean hysterectomy were included in the study. Results Group I had S.I. > 1.5, and group II had S.I. ≤ 1.5. Group I had more complications, but none were above Grade 3 or fatal. Preoperative scheduled uterine artery embolization did not result in serious complications, but three patients who had emergency common iliac artery balloon occlusion (CIABO) and a primary total hysterectomy with S.I. > 1.5 had postoperative Grade 2 thrombosis. Two patients underwent manual ablation of the placenta under CIABO to preserve the uterus, both with S.I. > 1.5. Conclusions The study found that the “Holding-up uterus” technique was safe, even in critical situations with S.I. > 1.5. CIABO had no intervention effect. The study also identified assisted reproductive technology pregnancies with a uterine cavity length of less than 5 cm before conception as a critical factor. |
| first_indexed | 2024-03-08T14:19:58Z |
| format | Article |
| id | doaj.art-3a8c8dd36dc94c859d2739a16773ebdd |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-03-08T14:19:58Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-3a8c8dd36dc94c859d2739a16773ebdd2024-01-14T12:07:13ZengBMCBMC Surgery1471-24822024-01-012411810.1186/s12893-024-02311-8Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series studyJin Takahashi0Makoto Orisaka1Daisuke Inoue2Hiroshi Kawamura3Nozomu Takahashi4Hideaki Tsuyoshi5Akiko Shinagawa6Tetsuji Kurokawa7Yoshio Yoshida8Department of Obstetrics and Gynecology, University of FukuiDepartment of Obstetrics and Gynecology, University of FukuiDepartment of Obstetrics and Gynecology, University of FukuiDepartment of Obstetrics and Gynecology, University of FukuiDepartment of Obstetrics and Gynecology, University of FukuiDepartment of Obstetrics and Gynecology, University of FukuiDepartment of Obstetrics and Gynecology, University of FukuiDepartment of Obstetrics and Gynecology, University of FukuiDepartment of Obstetrics and Gynecology, University of FukuiAbstract Background Placenta accreta spectrum (PAS) cesarean hysterectomy is performed under conditions of shock and can result in serious complications. This study aimed to evaluate the usefulness of the “Holding-up uterus” surgical technique with a shock index (S.I.) > 1.5. Methods Twelve patients who underwent PAS cesarean hysterectomy were included in the study. Results Group I had S.I. > 1.5, and group II had S.I. ≤ 1.5. Group I had more complications, but none were above Grade 3 or fatal. Preoperative scheduled uterine artery embolization did not result in serious complications, but three patients who had emergency common iliac artery balloon occlusion (CIABO) and a primary total hysterectomy with S.I. > 1.5 had postoperative Grade 2 thrombosis. Two patients underwent manual ablation of the placenta under CIABO to preserve the uterus, both with S.I. > 1.5. Conclusions The study found that the “Holding-up uterus” technique was safe, even in critical situations with S.I. > 1.5. CIABO had no intervention effect. The study also identified assisted reproductive technology pregnancies with a uterine cavity length of less than 5 cm before conception as a critical factor.https://doi.org/10.1186/s12893-024-02311-8Placenta accreta spectrumCesarean hysterectomyShock indexHolding-up uterus techniquePreoperative intervention |
| spellingShingle | Jin Takahashi Makoto Orisaka Daisuke Inoue Hiroshi Kawamura Nozomu Takahashi Hideaki Tsuyoshi Akiko Shinagawa Tetsuji Kurokawa Yoshio Yoshida Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study BMC Surgery Placenta accreta spectrum Cesarean hysterectomy Shock index Holding-up uterus technique Preoperative intervention |
| title | Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study |
| title_full | Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study |
| title_fullStr | Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study |
| title_full_unstemmed | Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study |
| title_short | Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study |
| title_sort | evaluation of the holding up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index a case series study |
| topic | Placenta accreta spectrum Cesarean hysterectomy Shock index Holding-up uterus technique Preoperative intervention |
| url | https://doi.org/10.1186/s12893-024-02311-8 |
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