- All Journals
- Al-Qadisiyah University
- Basrah University
- Kirkuk University
- Mosul University
- The Iraqi Borad for Medical Specialization
- University of Anbar
- University of Technology
- Al Mustafa University
- Al-Zahraa University for Women
- Alnoor University
- Kunooz University
- Misan University
- Ninevah University
- Tikrit University
- University of Al-Hamdaniya
- University of Kerbala
Modified Uterine Incision To Decrease Mortality And Morbidity In Placenta Accreta: Cohort Study | ||
| Kerbala Journal of Medicine | ||
| Article 1, Volume 8, Issue 1, 2015, Pages 2106-2112 PDF (0 K) | ||
| Authors | ||
| Falah A. Muhi; Ali Khairi Toman; Haitham F. Hamzha | ||
| Abstract | ||
| background: Placenta accreta is an un common but potentially lethal complication ofpregnancy. It occurs when the placenta is abnormally adherent to the uterinemyometrium causing massive obstetric hemorrhage and still the leading cause of pregnancy related deaths. The risk factors are previous lower segment cesarean section, previous uterine surgery, endometrial defect like Sherman syndrome, presence of sub mucous fibroid, previous manual removal of placenta, vigorous and repeated curettage, previous myomectomy. Objective: To find the best strategy for dealing with placenta accreta patients and to decrease the associated maternal mortality and morbidity. Patients And Methods: 30 patients admitted in Alhindiya hospital between January 2008 and December 2013. Cohort study was conducted between 2 groups of patients with different management strategy. One group underwent the ordinary procedure of Caesarian section, while modification of uterine incision were done for the other group considering opening the uterus at a site distant from the placenta (high U shape incision), and delivering the baby without disturbing the placenta, then closure of the uterus in order to enable elective hysterectomy to be done. Analysis of data was done. Results & discussion: Thirty cases of placenta accreta were identified between January 2008 and December 2013. Placenta accreta was diagnosed either with ultrasound or MRI examinations. The patients had been divided into two groups with different management strategy. Analysis of operative and post-operative complications was done, and we found that scheduled caesarean hysterectomy performed under controlled circumstances with modified high uterine incision without attempting to remove the placenta before hysterectomy was associated with significantly decreased maternal morbidity and mortality. Conclusion: Scheduled caesarean hysterectomy performed under controlled circumstances with modified high uterine incision without attempting to remove the placenta before hysterectomy was associated with significantly decreased maternal morbidity and mortality. | ||
| Keywords | ||
| Placenta accrete; invasive placentation; caesarian hysterectomy | ||
|
Statistics Article View: 175 PDF Download: 28 |
||