Segmental resection of anterior uterine wall in cases with placenta percreta: a modified technique for fertility preserving approach

J Matern Fetal Neonatal Med. 2018 May;31(9):1198-1203. doi: 10.1080/14767058.2017.1311862. Epub 2017 Apr 25.

Abstract

Aim: The aim of this study was to introduce a modified form of fertility preserving approach in cases with placenta percreta.

Methods: Eleven pregnant women with anterior placenta previa and suspected to have placenta percreta underwent cesarean section between 2015 and 2016 in Zeynep Kamil Women and Children's Health Training and Research Hospital. In all cases, following confirmation of placenta percreta diagnosis, a modified minimal invasive form of uterine preserving surgery was performed.

Results: During the present study period, 11 pregnant women who were confirmed to have placenta previa and placenta percreta underwent modified form of segmental resection. In all cases, modified form of segmental resection was successful except for the two cases. There were significant statistical differences between pre-postoperative hemoglobin and hematocrit levels (p = .003). There was a significant correlation between the volume of resected segment and number of transfusions (r = .760, p = .047). Postoperative blood transfusion was not needed in 4 cases. No maternal mortality or other postoperative complication was observed in any case.

Conclusion: A modified minimal invasive form of uterine preserving surgery seems to be safe and result in more cosmetic results with minimal blood loss.

Keywords: Placenta percreta conservative management; uterus preserving surgery.

MeSH terms

  • Blood Loss, Surgical
  • Blood Transfusion
  • Cesarean Section
  • Female
  • Fertility Preservation / methods*
  • Hematocrit
  • Hemoglobins / analysis
  • Humans
  • Minimally Invasive Surgical Procedures / methods
  • Obstetric Surgical Procedures / methods*
  • Placenta / surgery
  • Placenta Accreta / surgery*
  • Placenta Previa / surgery
  • Pregnancy
  • Turkey
  • Uterus / surgery*

Substances

  • Hemoglobins