当前位置： SCI文献检索 > ARCHIVES OF GYNECOLOGY AND OBSTETRICS期刊下所有文献 > Modified cesarean hysterectomy technique for management of cases of placenta increta and percreta at a tertiary referral hospital in Egypt.

Modified cesarean hysterectomy technique for management of cases of placenta increta and percreta at a tertiary referral hospital in Egypt.

Abstract：

PURPOSE:To evaluate the effect of a modified type II radical hysterectomy on maternal morbidities and mortality in cases with abnormally invasive placenta (AIP). METHODS:63 cases with AIP were managed at one of the largest referral centers in Egypt in a prospective study design. This technique entails devascularization of the uterus laterally on both sides and to clamp the uterus at the lowest possible point just below the level of the placenta while sparing the ureters. RESULTS:The difference between pre- and post-operative hemoglobin was only about 1 gm/dl, and the mean blood loss was 1673 ± 958 ml. There was a significant drop in the post-operative need for blood and blood product replacement, packed red blood cells (p = 0.013), fresh red blood cells (p < 0.001), and plasma units (p = 0.012). Operative time (skin to skin) averaged 190 ± 58.2 min as the technique is slow and utilizes meticulous hemostatic steps. ICU admission was 4.8% with a mean total hospital stay of 8.6 ± 3.6 days. Histopathological examination revealed 58 cases of placenta increta and five percreta cases. We also had 16 bladder injuries (25.4%) and two ureteric injuries, and no maternal mortalities. CONCLUSION:This technique reduces maternal morbidity and mortality while performing cesarean hysterectomy for cases with AIP.

journal_name

Arch Gynecol Obstet

journal_title

Archives of gynecology and obstetrics

authors

Hussein AM,Kamel A,Raslan A,Dakhly DMR,Abdelhafeez A,Nabil M,Momtaz M

doi

10.1007/s00404-018-5027-7

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

695-702

issue

3

eissn

0932-0067

issn

1432-0711

pii

10.1007/s00404-018-5027-7

journal_volume

299

pub_type

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