Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2017

Open Access 01-12-2017 | Research article

The effectiveness of double incision technique in uterus preserving surgery for placenta percreta

Authors: Ibrahim Polat, Burak Yücel, Ali Gedikbasi, Halil Aslan, Aysun Fendal

Published in: BMC Pregnancy and Childbirth | Issue 1/2017

Login to get access

Abstract

Background

Placenta percreta is a life-threatening condition that places patients at risk of massive bleeding. It necessitates very complicated surgery and can result in mortality. Caesarean hysterectomy is the accepted procedure worldwide; however, recent studies discussing conservative treatment with segmental resections have been published. Foetal extraction and segmental resection can be performed through the same incision (single uterine incision) or through two different incisions (double uterine incision). In this study, we aimed to evaluate the effectiveness and results of the double incision technique.

Methods

Twenty-two patients with a diagnosis of placenta percreta who underwent conservative surgery were included. Segmental resection was performed via single incision in ten patients and double incision in twelve patients.

Results

There was no difference between the patients who underwent segmental resection via single and double incision in terms of age, gravida, number of previous caesarean deliveries, gestational age at delivery, or rate of elective surgeries. The operation time, transfusion requirement, intensive care unit admission, total hospitalization and success of conservative surgery were comparable between the groups.

Conclusions

Based on the outcomes of our study, double uterine incision allows for the safe extraction of the foetus during uterus-preserving surgery in patients with placenta percreta without worsening the results compared to single uterine incision.

Trial registration

NCT02702024, Date of registration: February 26, 2016, retrospectively registered.
Literature
1.
Hemorrhage Obstetrical. In: Cunningham FG, Leveno KJ, Bloom SL, editors. Williams Obstetrics. 24th ed. USA: McGraw-Hill Education; 2012. p. 780–829.
2.
Atalay MA, Oz Atalay F, Cetinkaya DB. What should we do to optimise outcome in twin pregnancy complicated with placenta percreta? A case report. BMC Pregnancy Childbirth. 2015;15:289.CrossRefPubMedPubMedCentral
3.
Garmi G, Salim R. Epidemiology, etiology, diagnosis, and management of placenta accreta. Obstet Gynecol Int. 2012;2012:873929.PubMedPubMedCentral
4.
Committee on Obstetric P. Committee opinion no. 529: placenta accreta. Obstet Gynecol. 2012;120:207–11.CrossRef
5.
Palacios Jaraquemada JM, Pesaresi M, Nassif JC, Hermosid S. Anterior placenta percreta: surgical approach, hemostasis and uterine repair. Acta Obstet Gynecol Scand. 2004;83:738–44.CrossRefPubMed
6.
Teo SB, Kanagalingam D, Tan HK, Tan LK. Massive postpartum haemorrhage after uterus-conserving surgery in placenta percreta: the danger of the partial placenta percreta. BJOG. 2008;115:789–92.CrossRefPubMed
7.
Timmermans S, van Hof AC, Duvekot JJ. Conservative management of abnormally invasive placentation. Obstet Gynecol Surv. 2007;62:529–39.CrossRefPubMed
8.
Hays AM, Worley KC, Roberts SR. Conservative management of placenta percreta: experiences in two cases. Obstet Gynecol. 2008;112:425–6.CrossRefPubMed
9.
Wong VV, Burke G. Planned conservative management of placenta percreta. J Obstet Gynaecol. 2012;32:447–52.CrossRefPubMed
10.
Rac MW, Dashe JS, Wells CE, et al. Ultrasound predictors of placental invasion: the Placenta Accreta Index. Am J Obstet Gynecol. 2015;212(343):e341-–347.
11.
Palacios-Jaraquemada JM. Efficacy of surgical techniques to control obstetric hemorrhage: analysis of 539 cases. Acta Obstet Gynecol Scand. 2011;90:1036–42.CrossRefPubMed
12.
Palacios-Jaraquemada JM. Caesarean section in cases of placenta praevia and accreta. Best Pract Res Clin Obstet Gynaecol. 2013;27:221–32.CrossRefPubMed
13.
Fox KA, Shamshirsaz AA, Carusi D, et al. Conservative management of morbidly adherent placenta: expert review. Am J Obstet Gynecol. 2015;213:755–60.CrossRefPubMed
14.
Datta S, Ostheimer GW, Weiss JB, et al. Neonatal effect of prolonged anesthetic induction for cesarean section. Obstet Gynecol. 1981;58:331–5.PubMed
15.
Abbas F, Talati J, Wasti S, et al. Placenta percreta with bladder invasion as a cause of life threatening hemorrhage. J Urol. 2000;164:1270–4.CrossRefPubMed
16.
Hoffman MS, Karlnoski RA, Mangar D, et al. Morbidity associated with nonemergent hysterectomy for placenta accreta. Am J Obstet Gynecol. 2010;202(628):e621–625.
17.
Pelosi 3rd MA, Pelosi MA. Modified cesarean hysterectomy for placenta previa percreta with bladder invasion: retrovesical lower uterine segment bypass. Obstet Gynecol. 1999;93:830–3.PubMed
18.
Wright JD, Pri-Paz S, Herzog TJ, et al. Predictors of massive blood loss in women with placenta accreta. Am J Obstet Gynecol. 2011;205(38):e31–36.
19.
Clausen C, Lonn L, Langhoff-Roos J. Management of placenta percreta: a review of published cases. Acta Obstet Gynecol Scand. 2014;93:138–43.CrossRefPubMed
20.
Sentilhes L, Kayem G, Ambroselli C, et al. Fertility and pregnancy outcomes following conservative treatment for placenta accreta. Hum Reprod. 2010;25:2803–10.CrossRefPubMedPubMedCentral
21.
Cunningham KM, Anwar A, Lindow SW. The recurrence risk of placenta accreta following uterine conserving management. J Neonatal Perinatal Med. 2015;8:293–6.CrossRefPubMed
Metadata
Title
The effectiveness of double incision technique in uterus preserving surgery for placenta percreta
Authors
Ibrahim Polat
Burak Yücel
Ali Gedikbasi
Halil Aslan
Aysun Fendal
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2017
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-017-1262-3

Other articles of this Issue 1/2017

BMC Pregnancy and Childbirth 1/2017 Go to the issue

Research article

Impact of multi-professional, scenario-based training on postpartum hemorrhage in Tanzania: a quasi-experimental, pre- vs. post-intervention study

Research article

Timing of delivery in a high-risk obstetric population: a clinical prediction model

Research article

Postpartum hemorrhage prevention in Nepal: a program assessment

Research article

Institutional maternal and perinatal deaths: a review of 40 low and middle income countries

Study protocol

Arabin cervical pessary for prevention of preterm birth in cases of twin-to-twin transfusion syndrome treated by fetoscopic LASER coagulation: the PECEP LASER randomised controlled trial

Research article

Assessing emergency obstetric and newborn care: can performance indicators capture health system weaknesses?