Progressive Devascularization: A Novel Surgical Approach for Placenta Previa

Antonio Saad, Nathan Kirsch, George Saade, Gary Hankins

Research output: Contribution to journalArticle

Abstract

Background The gold standard for antenatal diagnosis of placenta previa is the transvaginal ultrasonography. In placenta previa cases, separation of placental and uterine tissues is challenging even for the most experienced surgeons. Life-threatening obstetrical complications from cesarean deliveries with placenta previa include peripartum hemorrhage, coagulopathy, blood transfusion, peripartum hysterectomy, and multiple organ failure. Cases We detailed the 3 cases of placenta previa that underwent bilateral uterine artery ligation; if hemostasis was not achieved, horizontal mattress sutures were placed in the lower uterine segment. All patients were discharged with minimal morbidity. Conclusion For patients with placenta previa and low risk for placenta creta, counseling should include the risk for maternal morbidity and criteria for pursuing peripartum hysterectomy. Our devascularization, a stepwise surgical approach, shows promising outcomes in placenta previa cases. Précis We propose a novel surgical approach, using a progressive devascularization surgical technique, for management of women with placenta previa, undergoing cesarean delivery.

Original languageEnglish (US)
Pages (from-to)e223-e226
JournalAJP Reports
Volume8
Issue number4
DOIs
StatePublished - Jan 1 2018

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Placenta Previa
Peripartum Period
Hysterectomy
Morbidity
Uterine Artery
Multiple Organ Failure
Hemostasis
Prenatal Diagnosis
Blood Transfusion
Placenta
Sutures
Ligation
Counseling
Ultrasonography
Mothers
Hemorrhage

Keywords

  • cesarean
  • devascularisation
  • hemorrhage
  • previa

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Progressive Devascularization : A Novel Surgical Approach for Placenta Previa. / Saad, Antonio; Kirsch, Nathan; Saade, George; Hankins, Gary.

In: AJP Reports, Vol. 8, No. 4, 01.01.2018, p. e223-e226.

Research output: Contribution to journalArticle

Saad, Antonio ; Kirsch, Nathan ; Saade, George ; Hankins, Gary. / Progressive Devascularization : A Novel Surgical Approach for Placenta Previa. In: AJP Reports. 2018 ; Vol. 8, No. 4. pp. e223-e226.
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