Delivery of a pregnant woman with placenta accreta and uterine scar after cesarean section with the formation of placental hernia. A clinical case
Background. There are rather small numbers of publications on the management of pregnant women and delivery in women with a uterine scar after repeat cesarean section and metroplasty. However, it is precisely these cases that are associated with a high risk of adverse outcomes, primarily massive bleeding and hysterectomies. The use of organ-sparing surgical obstetrical methods makes it possible to implement reproductive plans to the extent required and to prevent massive blood loss.Barinov S.V., Tirskaya Yu.I., Kadtsyna T.V., Lazareva O.V., Chulovsky Yu.I., Kovaleva Yu.A., Stotskaya T.A., Razdobedina I.N., Grebenyuk O.A., Shavkun I.A.
Case report. The paper describes a clinical case of repeat surgical delivery in a woman who has a uterine scar after 4 cesarean sections and 2 metroplasties and demonstrates the efficiency of a combined surgical treatment procedure for placenta accreta.
Conclusion. Combined surgical obstetrical techniques, such as bilateral ligation of the descending branch of the uterine artery, an external uterine assembly supraplacental suture, guided balloon tamponade by Zhukovsky’s uterine and vaginal balloon catheters, allow one to perform organ-sparing surgery for placenta previa and placenta accreta-induced bleeding and to reduce the volume of blood loss.
Keywords
placenta accreta
cesarean section
massive bleeding
organ-sparing treatments
Zhukovsky’s double balloon tamponade
uterine scar
References
- Виницкий А.А., Шмаков Р.Г., Чупрынин В.Д. Сравнительная оценка эффективности методов хирургического гемостаза при органосохраняющем родоразрешении у пациенток с врастанием плаценты. Акушерство и гинекология. 2017; 7: 68-74. [Vinitsky A.A., Shmakov R.G., Chuprynin V.D. Comparative evaluation of the efficiency of surgical hemostatic methods during organ-sparing delivery in patients with placenta increta. Akusherstvo i Ginekologiya (Obstetrics and Gynecology). 2017; 7: 68-74. (in Russian)]. https://dx.doi.org/10.18565/aig.2017.7.68-74.
- Palacios-Jaraquemada J.M. Caesarean section in cases of placenta praevia and accreta. Best Pract. Res. Clin. Obstet. Gynaecol. 2013; 27(2): 221-32. https://dx.doi.org/10.1016/j.jgyn.2014.10.007.
- Silver R.M. Abnormal placentation: placenta previa, vasa previa, and placenta accreta. Obstet. Gynecol. 2015; 126(3): 654-68. https://dx.doi.org/10.1097/AOG.0000000000001005.
- Vintzileos A.M., Ananth C.V., Smulian J.C. Using ultrasound in the clinical management of placental implantation abnormalities. Am. J. Obstet. Gynecol. 2015; 213 (4, Suppl.): S70-7. https://dx.doi.org/10.1016/j.ajog.2015.05.059.
- Курцер М.А., Бреслав И.Ю., Евтеев В.Б., Нормантович Т.О., Спиридонова Е.И., Платицин И.В., Григорьян А.М., Латышкевич О.А., Коноплянников А.Г. Сравнительная характеристика эндоваскулярных методов остановки кровотечения при placenta accreta. Вопросы гинекологии, акушерства и перинатологии. 2017; 16(5): 17-24. [Kurtser M.A., Bireslav I.Yu., Evteev V.B.,Normatovich T.O., Spiridonova E.I., Platitsin I.V. et al. Comparative characteristics of endovascular methods to stop bleeding in the presence of placenta accreta. Voprosy Ginekologii, Akusherstva i Perinatologii (Problems of Gynecology, Obstetrics, and Perinatology). 2017; 16(5): 17-24. (in Russian)].
- Cowan A.D., Miller E.S., Grobman W.A. Subsequent pregnancy outcome after B-lynch suture placement. Obstet. Gynecol. 2014; 124(3): 558-61. https://dx.doi.org/10.1097/AOG.0000000000000418.
- D’Antonio F., Palacios-Jaraguemada J., Lim P.S., Forlani F., Lanzone A., Timor-Tritsch .I, Cali G. Counseling in fetal medicine: evidence-based answers to clinical questions on morbidly adherent placenta. Ultrasound Obstet. Gynecol. 2016; 47(3): 290-301. https://dx.doi.org/10.1002/uog.14950.
- Barinov S.V., Zhukovsk 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. https://dx.doi.org/10.3109/14767058.2015.1126242.
- Tanaka M., Matsuzaki S., Kakigano A., Kumasawa K., Ueda Y., Endo M., Kimura T. Placenta accreta following hysteroscopic myomectomy. Clin. Case Rep. 2016; 4(6): 541-4. https://dx.doi.org/10.1002/ccr3.562.
- Баринов С.В., Тирская Ю.И., Медянникова И.В., Шамина И.В., Ралко В.В., Раздобедина И.Н., Гребенюк О.А., Ковалева Ю.А., Шавкун И.А. Новый подход к выполнению операции кесарева сечения при приращении предлежащей плаценты. Акушерство и гинекология. 2017; 10: 47-54. [Barinov S.V., Tirskaya Yu.I., Medyannikova I.V., Shamina I.V., Ralko V.V., Razdobedina I.N. et al. A new approach to performing cesarean section for placenta accrete et previa. Akusherstvo i Ginekologiya (Obstetrics and Gynecology). 2017; 10: 47-54. (in Russian)]. https://dx.doi.org/10.18565/aig.2017.10.47-54.
- Dildy G.A., Belfort M.A., Adair C.D., Destefano K., Robinson D., Lam G. et al. Initial experience with adual-balloon catheter for the management of postpartum hemorrhage. Am. J. Obstet. Gynecol. 2014; 210(2): 136. e1-6. https://dx.doi.org/10.1016/j.ajog.2013.09.015.
- Duan Y., Zhao J., Kang S., Fan S.P., Li M., Wang X.L., Tang Z.J. Double-balloon tamponade used to control postpartum hemorrhage due to placenta previa and/or placenta accreta. Gynecol. Reprod. Endocrinol. 2017; 1(1): 21-3. https://dx.doi.org/10.35841/2591-7994.1.1.21-23.
- Okumura M., Francisco R.P., Kondo M.M., Schultz R., Zugaib M. Ultrasound diagnosis and evaluation of the number of prior caesarean deliveries as risk factor for placenta accrete in placenta previa cases. Ultrasound Obstet. Gynecol. 2016; 48(Suppl. 1): 321-3. https://dx.doi.org/10.1002/uog.16974.
- Matsuzaki S., Yoshino K., Kumasawa K., Satou N., Mimura K., Kanagawa T. et al. Placenta percreta managed by transverse uterine fundal incision with retrograde cesarean hysterectomy: a novel surgical approach. Clin.. Case Rep. 2014; 2(6): 260-4. https://dx.doi.org/10.1002/ccr3.108.
- Hajmurad O.S., Choxi A.A., Zahid Z., Dudaryk R. Aortoiliac thrombosis following tranexamic acid administration during urgent cesarean hysterectomy: a case report. A Case Rep. 2017; 9(3): 90-3. https://dx.doi.org/10.1213/XAA.0000000000000535.
- Rajpal G., Pomerantz J.M., Ragni M.V., Waters J.H., Vallejo M.C. The use of thromboelastography for the peripartum management of a patient with platelet storage pool disorder. Int. J. Obstet. Anesth. 2011; 20(2): 173-7. https://dx.doi.org/10.1016/j.ijoa.2010.09.014.
- Revert M., Rozenberg P., Cottenet J., Quantin C. Intrauterine balloon tamponade for severe postpartum hemorrhage. Obstet. Gynecol. 2018; 131(1): 143-9. https://dx.doi.org/10.1097/AOG.0000000000002405.
- Lo A., St Marie P., Yadav P., Belisle E., Markenson G. The impact of Bakri balloon tamponade on the rate of postpartum hysterectomy for uterine atony. J. Matern. Fetal Neonatal Med. 2017; 30(10): 1163-6. https://dx.doi.org/10.1080/14767058.2016.1208742.
Received 07.02.2020
Accepted 27.05.2020
About the Authors
Sergey V. Barinov, MD, Professor, Head of the Department of Obstetrics and Gynecology №2 Omsk State Medical University.Tel.: +7(913)633-80-48. E-mail: barinov_omsk@mail.ru. ID ORCID: 0000-0002-0357-7097. Address: 644099, Russia, Omsk, Lenin’s street, 12.
Yulia I. Tirskaya, MD, Associate Professor, Department of Obstetrics and Gynecology №2 Omsk State Medical University.
Tel: +7(3812)24-06-58. E-mail: yulia.tirskaya@yandex.ru. ID ORCID: 0000-0001-5365-7119. Address: 644099, Russia, Omsk, Lenin’s street, 12.
Yuriy I. Chulovskiy, PhD, Associate Professor, Department of Obstetrics and Gynecology №2 Omsk State Medical University.
Tel.: +7(3812)24-06-58. E-mail: akusheromsk@rambler.ru. ID ORCID: 0000-0003-2541-7091. Address: 644099, Russia, Omsk, Lenin’s street, 12.
Tat’yana V. Kadcyna, PhD, Associate Professor, Department of Obstetrics and Gynecology №2 Omsk State Medical University.
Tel.: +7(3812)24-06-58. E-mail: tatianavlad@list.ru. ID ORCID: 0000-0002-0348-5985. Address: 644099, Russia, Omsk, Lenin’s street, 12.
Oksana V. Lazareva, PhD, Associate Professor, Department of Obstetrics and Gynecology №2 Omsk State Medical University.
Tel.: +7(3812)24-06-58. E-mail: lazow@mail.ru. ID ORCID: 0000-0002-0895-4066. Address: 644099, Russia, Omsk, Lenin’s street, 12.
Yuliya A. Kovaleva, Head of the Department of Pregnancy Pathology maternity hospital BUSOO “Regional Hospital”.
Tel.: +7(3812)24-13-52. E-mail: kovalevajulia71@yandex.ru. ID ORCID: 0000-0002-3689-1357. 644000, Russia, Omsk, ul. Birch, 3.
Tamara A. Stockaya, doctor of the Department of Pregnancy Pathology maternity hospital BUSOO “Regional Hospital”.
Tel.: +7(3812)24-13-52. E-mail: tamara.stotckaja@yandex.ru. ID ORCID: 0000-0002-6526-4328. 644000, Russia, Omsk, ul. Birch, 3.
Irina N. Razdobedina, Head of Department of obstetrics observational maternity hospital BUSOO “Regional Hospital”.
Tel.: +7(3812)25-15-78. E-mail: razdobedina@mail.ru. ID ORCID: 0000-0002-0281-9453. 644000, Russia, Omsk, ul. Birch, 3.
Olga A. Grebenuk, PhD, Head of the Department of obstetrics physiological maternity hospital BUSOO “Regional Hospital:
Tel.: +7(3812)24-13-52. E-mail: olgaomsk@inbox.ru. ID ORCID: 0000-0003-4080-2422. 644000, Russia, Omsk, ul. Birch, 3.
Inna A. Shavkun, doctor of the Department of obstetrics observational maternity hospital BUSOO “Regional Hospital”.
Tel.: +7(3812)25-15-78. E-mail: innashavkun.81@mail.ru. ID ORCID: 0000-0003-4956-4758. 644000, Russia, Omsk, ul. Birch, 3.
For reference: Barinov S.V., Tirskaya Yu.I., Kadtsyna T.V., Lazareva O.V., Chulovsky Yu.I., Kovaleva Yu.A., Stotskaya T.A., Razdobedina I.N., Grebenyuk O.A., Shavkun I.A. Delivery of a pregnant woman with placenta accreta and uterine scar after cesarean section with the formation of placental hernia. A clinical case.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 6: 141-146 (in Russian)
https://dx.doi.org/10.18565/aig.2020.6.141-146
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