Journal of

Case Reports and Images in Obstetrics and Gynecology

 
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Case Series
 
Modified retrograde cesarean hysterectomy for placenta previa accreta
Sato Hiroshi1, Taguchi Nao1, Imai Saeko1, Kawaharamura Kanako1, Suzuki Takako1, Hirose Masaya1
1Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center 2-17-77 Higashinaniwa, Amagasaki, Hyogo, Japan.

Article ID: 100013Z08SH2016
doi:10.5348/Z08-2016-13-CS-6

Address correspondence to:
Hiroshi Sato
Department of Obstetrics and Gynecology
Hyogo Prefectural Amagasaki General Medical Center 2-17-77 Higashinaniwa
Amagasaki, Hyogo, 660-8550
Japan

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How to cite this article:
Hiroshi S, Nao T, Saeko I, Kanako K, Takako S, Masaya H. Modified retrograde cesarean hysterectomy for placenta previa accreta. J Case Rep Images Gynecol Obstet 2016;2:25–30.


Abstract
Introduction: The incidence of placenta previa accreta continues to increase with rising cesarean section rates. Massive bleeding and/or urinary tract injury can occur in cesarean hysterectomy for placenta previa accreta and the operation is one of the most difficult obstetric surgeries. We designed "modified retrograde cesarean hysterectomy" for placenta previa accreta with combination of useful measures that were reported previously. We report this maneuver and investigate its utility.
Case Report: From January 2013 to February 2015, we performed "modified retrograde cesarean hysterectomy" in four Japanese pregnant women with placenta previa accreta who did not want to retain fertility. We retrospectively analyzed the medical records of these four cases. Mean blood loss during the operation was 2128±639 ml. Allogenic transfusion was performed in only one woman. A pathologic examination showed placenta accreta in three women, placenta increta in one woman. Placenta percreta was not found in any of the women. No intraoperative complication including urinary tract injury occurred. Postoperative course was uneventful in all of the women.
Conclusion: "Modified retrograde cesarean hysterectomy" can brought less maternal morbidity through avoidance of urinary tract injury. This operation is thought to be useful and safe for the patients with placenta previa accreta who do not need to preserve fertility.

Keywords: Cesarean section, Hysterectomy, Placenta accreta, Placenta previa


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Author Contributions:
Hiroshi Sato – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Nao Taguchi – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Saeko Imai – Acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Kanako Kawaharamura – Acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Takako Suzuki – Acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Masaya Hirose – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Hiroshi Sato et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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