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- Title
Surgical management of 58 patients with placenta praevia percreta.
- Authors
Camuzcuoglu, Aysun; Vural, Mehmet; Hilali, Nese; Incebiyik, Adnan; Yuce, Hasan; Kucuk, Ahmet; Camuzcuoglu, Hakan
- Abstract
Objective: The aim of this study is to present our experience with surgical management of placenta praevia percreta. Methods: This study was conducted from January 2009 through March 2014 at Harran University Hospital and was a chart review of all patients who underwent caesarean hysterectomy with the placenta left in situ for placenta praevia percreta. Results: The study group comprised 58 patients. All of the patients underwent ultrasound mapping of the placental area before surgery. Emergent caesarean hysterectomy was only performed in 9 patients; 49 patients underwent planned caesarean hysterectomy. Bilateral internal iliac artery ligation was performed in all cases. Four patients (6.9 %) had bladder damage, one patient (1.7 %) required cystotomy, and one patient (1.7 %) required re-operation because of postoperative hemorrhage. The mean operative time was 141.6 (range: 95-355) minutes. Only 17 (29.3 %) patients were administered more than four units of red blood cells. There was no ureteral damage or maternal death. Furthermore, there were no complications in 42 (72.4 %) patients. Conclusions: Caesarean hysterectomy for placenta praevia percreta is associated with increased maternal morbidity. However, preoperative diagnosis of placenta praevia percreta, ultrasound mapping of the placenta, and the presence of a multidisciplinary experienced team may decrease maternal morbidity and mortality. Moreover, the urinary system may be protected in the patients with placenta praevia percreta without serious morbidity.
- Subjects
PLACENTA praevia; HYSTERECTOMY; SURGICAL blood loss; CESAREAN section; URINARY organs; THERAPEUTICS
- Publication
Wiener Klinische Wochenschrift, 2016, Vol 128, Issue 9/10, p360
- ISSN
0043-5325
- Publication type
Article
- DOI
10.1007/s00508-016-0962-4