A new approach to cesarean section for placenta previa accreta
Objective. To evaluate the efficiency of combined tactics using the Zhukovsky vaginal and uterine catheters when stopping postpartum bleeding due to placenta previa increta.Barinov S.V., Tirskaya Yu.I., Medyannikova I.V., Shamina I.V., Ralko V.V., Razdobedina I.N., Grebenyuk O.A., Kovaleva Yu.A., Shavkun I.A.
Subjects and methods. The investigation enrolled 79 pregnant women with rotation of the placenta previa. Surgical treatment (uterine arterial ligation; compression sutures; dissection of the ingrown lobe of the placenta or metroplasty) was used in Group 1; a surgical technique was used in combination with the Zhukovsky uterine balloon catheter in Group 2; surgical hemostasis was combined with the Zhukovsky uterine and vaginal catheters in Group 3.
Resu1ts. Blood loss during surgical hemostasis in combination with the Zhukovsky catheters was significantly lower than that during isolated surgical hemostasis. There was no difference in blood loss when the uterine catheter was used alone or in combination of the vaginal catheter
Conclusion. The use of the Zhukovsky catheters permits one to perform organ-sparing surgery for placenta previa and lower-segment bleeding due to placenta accreta.
Keywords
placenta previa
placenta accreta
obstetric hemorrhage
organ-sparing technique for obstetric hemorrhage
Supplementary Materials
- Table 1. Evaluation of the effectiveness of haemostatic measures
- Table 2. Comparison of the results of compared methods of hemostasis with respect to an unfavorable outcome
- Fig. 1. Hemostatic external-uterine supraplacental assembly suture
- Fig. 2. Installation of uterine obstetric Zhukovsky catheter
- Fig. 3. Installation of vaginal and uterine Zhukovsky catheters
- Fig. 4. Indices of blood loss in volume compared groups (▫Mean ± SE; + Mean ± 2 * SD), p = 0.0029
- Fig. 5. Indicators volume blood loss in the two groups (▫Mean ± SE; + Mean ± 2 * SD), p = 0.0137
- Fig. 6. Performance volume blood loss in the two groups (▫Mean ± SE; + Mean ± 2 * SD), p = 0.7084
References
1. Wu S., Kocherglnsky M., Hibbard J.U. Abnormal placentation: twenty-year analysis. Am. J. Obstet. Gynecol. 2005; 192(5): 1458-61. doi: 10.1016/j.ajog.2004.12.074.
2. Винницкий А.А., Шмаков Р.Г. Современные представления об этиопатогенезе врастания плаценты и перспективы его прогнозирования молекулярными методами диагностики. Акушерство и гинекология. 2017; 2: 5-10. doi: 10.18565/aig.2017.2.5-10. [Vinitskiy A.A., Shmakov R.G. The modern concepts of etiology and pathogenesis placenta accreta and prospects of its prediction by molecular diagnostics. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (2): 5-10. (in Russian http://dx.doi.org/10.18565/aig.2017.2.5-10]
3. Fitzpatrick K.E., Sellers S., Spark R., Kurinczuk J.J., Brocklehurst P., Knight M. Incidence and risk factors for placenta accreta/increta/percreta in the UK: a national case-control study. PLoS One. 2012; 7(12): e52893. doi: 10.1371/journal.pone.0052893.
4. Creanga A.A., Bateman B.T., Butwick A.J., Raleigh L., Maeda A., Kukllna E. et al. Morbidity associated with cesarean delivery in the United States: is placenta accreta an increasingly important contributor? Am. J. Obstet. Gynecol. 2015; 213(3): 384. el-11. doi: 10.1016/j.ajog.2015.05.002.
5. Clark S.L., Koonings P.P., Phelan J.P. Placenta previa/accreta and prior cesarean section. Obstet. Gynecol. 1985; 66(1): 89-92.
6. Shrivastava V., Nageotte M., Major C, Haydon M., Wing D. Case-control comparison of cesarean hysterectomy with and without prophylactic placement of intravascular balloon catheters for placenta accreta. Am. J. Obstet. Gynecol. 2007; 197(4): 402. е1-5. doi: 10.1016/j.ajog.2007.08.001.
7. Курцер М.А., Бреслав И.Ю., Латышкевич О.А., Григорян А.М. Временная баллонная окклюзия общих подвздошных артерий у пациенток с рубцом на матке после кесарева сечения и placenta accrete. Преимущества и возможные осложнения. Акушерство и гинекология. 2016; 12: 70-5. http://dx.doi.org/10.18565/aig.2016.12.70-5 [Kurtser M.A., Breslav I.Yu., Latyshkevich O.A., Grigoryan A.M. Temporary balloon occlusion of the common iliac arteries in patients with post-cesarean uterine scar and placenta accreta: Advantages and possible complications. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2016; (12): 70-5. (in Russian) http://dx.doi.org/10.18565/aig.2016.12.70-5]
8. Курцер М.А., Бреслав И.Ю., Латышкевич О.А., Лукашина М.В., Штабницкий A.M. Опыт выполнения органосохраняющей операции при placenta accreta у пациентки с бихориальной двойней. Вопросы гинекологии, акушерства и перинатологии. 2015; 14(4): 75-8. [Kurtser MA, Breslav I.Y., Latyshevich O.A, Lukashina M.V, Stabnitsky A.M. Experience of preserving surgery for placenta accreta in a patient with twins pregnancy. Voprosyi ginekologii, akusherstva i perinatologii. 2015; 14(4): 75-8. (in Russian)]
9. Committee on Obstetric Practice. Committee opinion no. 529: placenta accreta. Obstet. Gynecol. 2012; 120(1): 207-11. doi: 10.1097/AOG.0b013e318262e340.
10. Silver R.M., Barbour K.D. Placenta accreta spectrum: accreta, increta, and percreta. Obstet. Gynecol. Clin. North Am. 2015; 42(2): 381-402. doi: 10.1016/j.ogc.2015.01.014.
11. Palacios Jaraquemada J.M., Pesaresi M., Nassif J.C., Hermosid S. Anterior placenta percreta: surgical approach, hemostasis and uterine repair. Acta Obstet. Gynecol. Scand. 2004; 83(8): 738-44. doi: 10.1111/j.0001-6349.2004.00517.x.
12. D’Souza D.L., Kingdom J.C., Amsalem H., Beecroft JR., Windrim R.C., Kachura J.R. Conservative management of invasive placenta using combined prophylactic internal iliac artery ballon occlusion and immediate postoperative uterine artery embolization. Can. Assoc. Radiol. J. 2015; 66(2): 179-84. doi: 10.1016/j.carj.2014.08.002.
13. Курцер М.А., Бреслав И.Ю., Григорян А.М., Латышкевич О.А. Опыт использования временной баллонной окклюзии общих подвздошных артерий при органосохраняющих операциях у пациентов с врастанием плаценты. Акушерство и гинекология. 2013; 7: 80-4. [Kurcer M.A., Breslav I.Y., Grigoryan A.M., Latyshkevich O.A. Experience in the use of temporary balloon occlusion of common iliac arteries in organ-saving operations in patients with placenta ingrowth. Akusherstvo i Ginekologiya/Obstetrics and gynecology. 2013; 7: 80-84. (in Russian)]
14. Barinov S.V., Zhukovsky Y.G., Dolgikh T.I., Medyannikova I.V. Novel combined strategy of obstetric haemorrhage management during caesarean section using intrauterine balloon tamponade. J. Matern. Fetal Neonatal Med. 2017; 30(1): 29-33. doi: 10.3109/14767058.2015.1126242.
15. Пат. 2619404, Российская Федерация. МПК А61В/17/42 (2006.01). Баринов С.В., Тирская Ю.И., Медянникова И.В., Жилин А.В. Способ остановки послеродового кровотечения. Заявлено 09.03.2016; Опубликовано 15.05.2017, Бюл. № 14. [Method for stopping postpartum haemorrhage: patent 2619404 Rus. Federation : МПК А61В/17/42 (2006.01). Barinov S.V., Tirskaya Y.I., Medyannikova I.V., Zhilin A.V. ; applicant and patent holder of the state budgetary educational institution of higher education “Omsk State Medical University” of the Ministry of Health of the Russian Federation. – №2016108378; decl. 09.03.2016; publ. 15.05.2017, Bul. № 14. (in Russian)]
Received 09.06.2017
Accepted 23.06.2017
About the Authors
Barinov Sergej Vladimirovich, doctor of medical sciences, professor, head of the department of obstetrics and gynecology № 2, Omsk State Medical University.644043, Russia, Omsk, Lenina str. 12. Tel.: +73821240658. E-mail: barinov_omsk@mail.ru
Tirskaya Yuliya Igorevna, doctor of medical sciences, docent, associate professor at the department of obstetrics and gynecology № 2, Omsk State Medical University. 644043, Russia, Omsk, Lenina str. 12. Tel.: +73821240658. E-mail: yulia.tirskaya@yandex.ru
Medyannikova Irina Vladimirovna, candidate of medical sciences, associate professor at the department of obstetrics and gynecology № 2, Omsk State Medical University. 644043, Russia, Omsk, Lenina str. 12. Tel.: +73821240658. E-mail: mediren@gmail.com
Shamina Inna Vasil’evna, candidate of medical sciences, assistant professor at the department of obstetrics and gynecology № 2, Omsk State Medical University.
644043, Russia, Omsk, Lenina str. 12. Tel.: +73821240658. E-mail: innadocsever@rambler.ru
Ralko Vyacheslav Vladimirovich, candidate of medical sciences, deputy chief physician for obstetrical and gynecological aid, Omsk Regional Clinical Hospital.
644111, Russia, Omsk, Berezovaya str. 3. Tel.: +73821359104. E-mail: okb_mail@minzdrav.omskportal.ru
Razdobedina Irina Nikolaevna, head of the obstetrics department, Omsk Regional Clinical Hospital.
644111, Russia, Omsk, Berezovaya str. 3. Tel.: +73821359104. E-mail: okb_mail@minzdrav.omskportal.ru
Grebenyuk Ol’ga Al’bertovna, head of the obstetric physiological department, Omsk Regional Clinical Hospital.
644111, Russia, Omsk, Berezovaya str. 3. Tel.: +73821359104. E-mail: okb_mail@minzdrav.omskportal.ru
Kovaleva Yuliya Anatol’evna, head of pregnancy pathology department, Omsk Regional Clinical Hospital.
644111, Russia, Omsk, Berezovaya str. 3. Tel.: +73821359104. E-mail: okb_mail@minzdrav.omskportal.ru
Shavkun Inna Anatol’evna, doctor obstetrician-gynecologist obstetric observatory department, Omsk Regional Clinical Hospital.
644111, Russia, Omsk, Berezovaya str. 3. Tel.: +73821359104. E-mail: okb_mail@minzdrav.omskportal.ru
For citations: Barinov S.V., Tirskaya Yu.I., Medyannikova I.V., Shamina I.V., Ralko V.V., Razdobedina I.N., Grebenyuk O.A., Kovaleva Yu.A., Shavkun I.A. A new approach to cesarean section for placenta previa accreta. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (10): 47-54. (in Russian)
https://dx.doi.org/10.18565/aig.2017.10.47-54
Similar Articles
