TITLE:
A Seven-Step Approach to Control Severe Hemorrhage in Cesarean Delivery with the Placenta Accreta Spectrum Disorders Avoiding Hysterectomy
AUTHORS:
Shili Su, Yanmin Gong, Hongyan Wang, Yunguang Li
KEYWORDS:
Placenta Accreta Spectrum, Placenta Previa, Cesarean, Postpartum Hemorrhage, Hysterectomy
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.12 No.10,
October
9,
2022
ABSTRACT: Objectives: To describe a novel procedure to treat hemorrhage of placenta accreta
spectrum disorders (PAS) or cesarean-scar pregnancy (CSP). Methods: This
was a retrospective study of women under cesarean delivery with PAS or placenta
previa. Patients’ information was acquired from hospital records. A novel
procedure of surgery is developed with seven major steps, including avoiding placenta incised, elevating upward the uterine, clamping the
uterine arteries with sponge forceps, removing the placenta, opening the
vesicouterine space and suture techniques. Results: A total of 38
patients were reviewed. Twenty-one patients diagnosed with placenta accrete
syndrome and 3 patients with CSP were underwent surgery with the novel
procedure of surgery and all severe hemorrhage was controlled without
hysterectomy. There were 2 women with bladder injuries needing primary repair. Fourteen patients with placenta previa underwent
cesarean delivery and there was no intraoperative complication of the total 14
patients. Conclusion: The seven-step approach is more secure and
effective to control severe hemorrhage without other invasive procedures in cesarean
delivery with PAS. It is technically easier to maintain
and improve surgical skills.