Local resection for placenta accreta spectrum: a conservative uterus sparing technique for anterior placenta accreta

Year 2019, Volume: 5 Issue: 1, 50 - 57, 04.01.2019

Gülsüm Uysal , Nefise Tanrıdan Okçu , Eda Eskimez Esra Saygılı Yılmaz

https://doi.org/10.18621/eurj.382390

Cited By: 1

Abstract

Objective: To evaluate and describe a surgical approach for
uterine preservation and management of postpartum hemorrhage in placenta
accreta spectrum (PAS).

Methods: We analyzed the data of
patients who were diagnosed with placenta previa companied with PAS prenatally
and subsequently performed cesarean section with local resection technique to
manage postpartum hemorrhage and uterine preservation at our tertiary care
center between January 2016 and August 2017. The technique includes the local
resection of placental invasion site and suturing the new uterine edges without
internal iliac artery ligation.

Results: The diagnosis of placenta
accreta spectrum anterior in all 11 cases was confirmed intraoperatively. Only
1 case underwent hysterectomy in a second operation. Two of cases had bladder
injury. The mean operative time was 99 ± 30 minutes. The mean received packed red
blood cells was 2.3 ± 1.0 units. The mean length of postoperative hospital stay
was 4.5 ± 1.4 days. There was no late complications regarding coagulopathy and infection.
No maternal mortality was observed.

Conclusion: Local resection is an
effective, safe and fertility preserving approach in selected patients with
PAS. 

Keywords

Placenta accreta spectrum, maternal morbidity, fetal outcome, fertility preservation, uterus preserving surgery, local resection

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