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Caesarean hysterectomy for placenta praevia/accreta using an approach via the pouch of Douglas
Author(s) -
Selman AE
Publication year - 2016
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.13762
Subject(s) - placenta accreta , medicine , placenta percreta , hysterectomy , obstetrics , caesarean section , pregnancy , placenta , gynecology , fetus , surgery , genetics , biology
Placenta praevia/accreta is associated with significant maternal morbidity and mortality and is a common cause of obstetric hysterectomy. This paper describes posterior retrograde abdominal hysterectomy, a new surgical technique for caesarean hysterectomy, in 11 women with placenta percreta, increta or accreta There were no intraoperative or postoperative maternal complications, and only one fetus required admission to the neonatal unit, for prematurity. Our technique in placenta praevia/accreta allows easy identification of the vagina and early uterine devascularisation, as well as safe resection of the involved urinary bladder in women with placenta percreta showing bladder penetration. Analytical studies are needed to confirm our findings. Tweetable abstract Posterior retrograde abdominal hysterectomy in women with placenta praevia/accreta may enable safer surgery.