Open AccessImportant surgical measures and techniques at cesarean hysterectomy for placenta previa accreta
Author(s) -
Matsubara Shigeki,
Kuwata Tomoyuki,
Usui Rie,
Watanabe Takashi,
Izumi Akio,
Ohkuchi Akihide,
Suzuki Mitsuaki,
Nakata Manabu
Publication year - 2013
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12074
Subject(s) - medicine , placenta previa , parametrium , placenta accreta , hysterectomy , cervix , ureter , surgery , laparoscopy , uterus , obstetrics , pregnancy , placenta , gynecology , fetus , genetics , cancer , biology
Abstract For cesarean hysterectomy with placenta previa accreta, “universally achievable” measures are required. We propose eight measures: (i) placement of intra‐iliac arterial occlusion balloon catheters; (ii) placement of ureter stents; (iii) “holding the cervix” to identify the site to be transected; (iv) uterine fundal incision; (v) avoidance of uterotonics; (vi) “M cross double ligation” for ligating the ovarian ligament; (vii) “filling the bladder” to identify the bladder separation site and “opening the bladder” for placenta previa accreta with bladder invasion; and (viii) to continue to clamp the medial side of the parametrium or the cervix or employment of the “double edge pick‐up” to ligate it. These eight measures are simple, easy, effective, and thus “universally achievable”.