Caesarean hysterectomy and allied operations, 1956

1957 ◽  
Vol 32 (S2) ◽  
pp. 85-85
Keyword(s):  
Caesarean Hysterectomy

scholarly journals Delayed bleeding after prophylactic bilateral internal iliac artery balloon occlusion in elective caesarean hysterectomy for the management of placenta accreta

2017 ◽  
Vol 6 (4) ◽  
pp. 1656
Author(s):  
Abdul Karim Othman ◽  
Noraslawati Razak ◽  
Mohd Hanif Che Mat
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Placenta Previa ◽  
Balloon Occlusion ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
Internal Iliac ◽  
Life Threatening ◽  
Caesarean Hysterectomy ◽  
Placenta Accrete

Morbidly adherent placenta (MAP) can be divided into placenta accrete, placenta increta and placenta percreta. It is associated with high parity, multifetal gestation, advanced maternal age, assisted reproductive technologies, placenta previa, and more importantly a history of caesarean section or uterine surgery. Globally, the incidence of placenta accrete has increased and seems to be in parallel with the increasing rate of caesarean section delivery.Despite rapidly evolving diagnostic imaging, and growing of surgical expertise, morbidly adherent placenta (MAP) remains an important cause of maternal morbidity and mortality, especially related with life-threatening postpartum haemorrhage. Although the choice of treatment for placenta accrete is puerperal hysterectomy, this procedure itself involves a greater risk of intra-operative haemorrhage.Elective caesarean hysterectomy using prophylactic bilateral internal iliac artery balloon occlusion offer an interesting approach which can minimize the risk of intra-operative haemorrhage. However, our case report describes the case of a 28-year old Gravida 3 Para 2 morbidly obese parturient diagnosed to have placenta previa type 3 posterior with accrete who experienced a complication of life threatening massive bleeding post-operatively after an elective caesarean hysterectomy using a prophylactic bilateral internal iliac artery balloon occlusion intra-operatively.

scholarly journals Efficacy of colour doppler imaging in prediction of placenta accrete

2017 ◽  
Vol 6 (10) ◽  
pp. 4377
Author(s):  
Rachna Agarwal ◽  
Sruthi Bhaskaran ◽  
Esha Gupta ◽  
Dipanvita Dutta ◽  
Anupama Tandon
Keyword(s):  
Placenta Accreta ◽  
Placenta Previa ◽  
Color Doppler ◽  
Color Doppler Imaging ◽  
Final Diagnosis ◽  
Doppler Imaging ◽  
Colour Doppler ◽  
Grey Scale ◽  
Transfusion Requirements ◽  
Caesarean Hysterectomy

Background: In present scenario of increasing cases of previous caesarean section the diagnosis of Placenta accreta preoperatively is of great value to the attending obstetrician. This helps in preparing, counselling the patient and also in assembling a multidisciplinary team for effective peripartum clinical management of these patients to prevent maternal morbidity and mortality.Methods: One hundred patient with persistent placenta previa after 28 weeks gestation were screened by grey scale B mode sonography. In suspicious cases of placenta accreta, further assessment by colour Doppler ultrasound was done. The color doppler imaging (CDI) criteria used were - diffuse intra parenchymal placental lacunar flow, focal intra parenchymal placental lacunar flow, bladder-uterine serosa interphase hypervascularity, prominent sub-placental venous complex and loss of sub-placental vascular signal in areas lacking peripheral sub-placental hypoechoic zone. Patients were prospectively followed up till delivery and the CDI findings were analysed with reference to final diagnosis made during caesarean section.Results: Six of hundred patients exhibited characteristic CDI patterns highly specific for placenta accreta according to the criteria used. In all 6 patients, morbidly adherent placenta was present intraoperatively. The sensitivity and specificity of CDI in the diagnosis of placenta accreta in presentstudy was 100%. Caesarean hysterectomy was required in five patients. Patients with CDI features of lacunar flow had higher incidence of blood loss, transfusion requirements and need for caesarean hysterectomy compared to patients with nonlacunar flow. The remaining 94 patients with placenta previa, not suspicious for placenta accreta on sonography underwent uncomplicated caesarean section.Conclusions: The use of CDI along with conventional grey-scale sonography improves the diagnostic accuracy for prediction of placenta accreta in patients with persistent placenta previa.

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