Multistep approach for control of postpartum hemorrhage in placenta accreta: a novel scheme in a tertiary referral center

Authors

  • Ahmed Samy El-Agwany Department of Obstetrics and Gynaecology, El-shatby maternity hospital, Alexandria University, Alexandria, Egypt
  • Tamer Mamdouh Abdeldayem Department of Obstetrics and Gynaecology, El-shatby maternity hospital, Alexandria University, Alexandria, Egypt

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20162669

Keywords:

Placenta, Accreta, Hysterectomy, Ultrasound, Hemorrhage

Abstract

Background: Placenta accreta is a major cause for massive postpartum hemorrhage and consequent obstetric hysterectomy. Incidence is rising secondary to increased rates of caesarian delivery worldwide.

Methods: From January 2014 to January 2016, 25 women with anterior low-lying placenta and previous caesarian section(s) were recruited at El-Shatby Maternity university hospital in Alexandria, Egypt.  Cases had previous 1-4 lower segment caesarian deliveries. Cases were diagnosed as placenta accreta by ultrasonographic examination on admission to hospital. Elective surgery was done at 36-37 weeks. Mid line abdominal incision with upper segment uterine incision with plication of lowers uterine segment with transverse compression sutures.

Results: We present a clinical trial for conservative management of placenta accreta in 25 cases with 19 cases [76%] successfully managed without hysterectomy.

Conclusions: Conservative management of placenta accreta can be successfully performed in young age females desiring fertility.

Metrics

Metrics Loading ...

References

Palova E, Redecha M, Malova A, Hammerova L, Kosibova Z. Placenta accreta as a cause of peripartum hysterectomy. Bratisl Lek Listy. 2016;117(4):212-6.

El-Agwany AS. Bilateral Absence of Common Iliac Artery: Abnormal anatomical variation of the Internal Iliac Artery during Ligation in Conservative Surgical Management of Placenta Previa Accreta Indian Journal of Gynecologic Oncology. 2016;14(2):1-6.

D'Antonio F, Iacovella C, Bhide A. Prenatal identification of invasive placentation using ultrasound: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2013;42(5):509-17.

El-Hamamy E, Wright A, B-Lynch C. The B-Lynch suture technique for postpartum haemorrhage: a decade of experience and outcome. J Obstet Gynaecol. 2009;29(4):278-83.

Ghezzi F, Cromi A, Uccella S, Raio L, Bolis P, Surbek D. The hayman technique: a simple method to treat postpartum haemorrhage. BJOG. 2007;114(3):362-5.

AbdRabbo SA. Stepwise uterine devascularization: a novel technique for management of uncontrolled postpartum hemorrhage with preservation of the uterus. Am J Obstet Gynecol. 1994;171(3):694-700.

Yildiz C, Akkar OB, Karakuş S, Cetin A, Yanik A. Hypogastric artery ligation for obstetrical hemorrhage: clinical experience in a tertiary care center. Turk J Med Sci. 2015;45(6):1312-6.

Winograd RH. Uterine artery embolization for postpartum hemorrhage. Best Pract Res Clin Obstet Gynaecol. 2008;22(6):1119-32.

Soro MP, Denys A, de Rham M, Baud D. Short and long term adverse outcomes after arterial embolisation for the treatment of postpartum haemorrhage: a systematic review. Eur Radiol. 2016: PMID: 27229338.

Akdemir N, Cevrioğlu AS, Özden S, Gündüz Y, Ilhan G. Successful treatment of placenta percreta through a combinatorial treatment involving a Bakri Balloon and Methotrexate a case report. Ginekol Pol. 2015;86(8):631-4.

Chester J, Sidhu P, Sharma S, Israfil-Bayli F. Emergency peripartum hysterectomies at a District General Hospital in United Kingdom: 10-year review of practice. Scientifica. 2016;2016:9875343.

Li GT, Li XF, Wu B, Li G. Longitudinal parallel compression suture to control postpartum hemorrhage due to placenta previa and accreta. Taiwan J Obstet Gynecol. 2016;55(2):193-7.

Shazly SA, Badee AY, Ali MK. The use of multiple compressions suturing as a novel procedure to preserve fertility in patients with placenta accreta: case series. Aust N Z J Obstet Gynaecol. 2012;52(4):395-9.

Chandraharan E, Rao S, Belli AM, Arulkumaran S The triple-P procedure as a conservative surgical alternative to peripartum hysterectomy for placenta percreta. Int J Gynaecol Obstet. 2012;117(2):191-4.

Kaplanoğlu M. The Uterine Sandwich Method for Placenta Previa Accreta in Mullerian Anomaly: Combining the B-Lynch Compression Suture and an Intrauterine Gauze Tampon. Case Reports in Obstetrics and Gynecology. 2013;236069.

Mechsner S, Baessler K, Brunne B, Albrecht T, Hopp H, Dudenhausen JW. Using recombinant activated factor VII, B-lynch compression, and reversible embolization of the uterine arteries for treatment of severe conservatively intractable postpartum hemorrhage: new method for management of massive hemorrhage in cases of placenta increta. Fertil Steril. 2008;90(5):2012.e1-5.

Cunningham KM, Anwar A, Lindow SW. The recurrence risk of placenta accreta following uterine conserving management. J Neonatal Perinatal Med. 2016;8(4):293-6.

Downloads

Published

2017-01-11

How to Cite

El-Agwany, A. S., & Abdeldayem, T. M. (2017). Multistep approach for control of postpartum hemorrhage in placenta accreta: a novel scheme in a tertiary referral center. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 5(8), 2799–2803. https://doi.org/10.18203/2320-1770.ijrcog20162669

Issue

Section

Original Research Articles