Placenta percreta with a vaginal fistula after successful management by uterine transverse fundal incision and subsequent cesarean hysterectomy
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Placenta previa presents a highest risk to pregnancy, and placenta accreta is the most serious. Placenta accreta requirescesarean delivery and often results in massive obstetric hemorrhage and higher maternal morbidity. Challengesassociated with cesarean delivery techniques may contribute to increased maternal blood loss and morbidity rates. Several recent obstetric studies reported the usefulness of transverse uterine fundal incision for managing placentaaccreta. We present a case of placenta percreta that was treated by a transverse fundal incision. We successfullyavoided cutting through the placenta and helped decrease maternal blood loss. After delivery, the patient underwenta cesarean hysterectomy. Postoperative day 48, she experienced watery discharge and was diagnosed with vaginalfistula. We present our case and review the literature.
Abstract
Placenta previa presents a highest risk to pregnancy, and placenta accreta is the most serious. Placenta accreta requirescesarean delivery and often results in massive obstetric hemorrhage and higher maternal morbidity. Challengesassociated with cesarean delivery techniques may contribute to increased maternal blood loss and morbidity rates. Several recent obstetric studies reported the usefulness of transverse uterine fundal incision for managing placentaaccreta. We present a case of placenta percreta that was treated by a transverse fundal incision. We successfullyavoided cutting through the placenta and helped decrease maternal blood loss. After delivery, the patient underwenta cesarean hysterectomy. Postoperative day 48, she experienced watery discharge and was diagnosed with vaginalfistula. We present our case and review the literature.
참고문헌 (6)
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- Matsubara S, "Important surgical measures and techniques at cesarean hysterectomy for placenta previa accreta", Acta Obstet Gynecol Scand, 92, pp.372~377 (2013)
- Shukunami K, "Transverse fundal uterine incision in a patient with placenta increta", J Matern Fetal Neonatal Med, 16, pp.355~356 (2004)
- Kotsuji F, "Transverse uterine fundal incision for placenta praevia with accreta, involving the entire anterior uterine wall: a case series", BJOG, 120, pp.1144~1149 (2013)
- Nishida R, "Usefulness of transverse fundal incision method of cesarean section for women with placentas widely covering the entire anterior uterine wall", J Obstet Gynaecol Res, 39, pp.91~95 (2013)
- Clausen C, "Management of placenta percreta: a review of published cases", Acta Obstet Gynecol Scand, 93, pp.138~143 (2014)