Successful organ-sparing surgical treatment in a patient with the placenta previa growing into the uterine scar region

Ralnikova A.Yu., Bezhenar V.F., Arakelyan B.V., Linde V.A., Gabelova K.A., Molchanov O.L.

1) Academician I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia; 2) City Aleksandrovskaya Hospital, Saint Petersburg, Russia
Background. Placenta increta is one of the most serious pregnancy complications, which leads to massive blood loss and hysterectomy.
Case report. This paper demonstrates a clinical case of successful delivery in a patient with placenta previa partialis and placenta increta into the uterine scar region. During an operation, a technique for temporary extravasal occlusion of the common iliac artery using silicone tourniquets was applied, followed by excision of the ingrowth site and by metroplasty.
Conclusion. The approach could achieve minimal blood loss, the optimal time for surgical intervention, a reduction in the length of hospital stay, and favorable obstetric and perinatal pregnancy outcomes, as well as preserve a patient’s menstrual and reproductive functions.

Keywords

placenta increta
pregnancy
organ-sparing surgery
massive blood loss
placenta previa
surgical hemostasis
occlusion of the common iliac arteries

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Received 08.10.2019

Accepted 29.11.2019

About the Authors

Anna Yu. Ralnikova, obstetrician-gynecologist of the obstetric department of pregnancy pathology of the obstetrics and gynecology clinic of FSBEI HE “First St. Petersburg State Medical University named after academician I.P. Pavlov Ministry of Health of the Russian Federation. Tel.: +7(812)338-7866, e-mail: anna.ralnikova15.10@gmail.com
197022, St. Petersburg, ul. Leo Tolstoy, 6-8.
Vitaly F. Bezhenar, MD, professor, head of the Department of Obstetrics, Gynecology and Neonatology FSBEI HE “First St. Petersburg State Medical University named
after Academician I.P. Pavlov Ministry of Health of the Russian Federation. Tel.: +7 (812)338-7866, e-mail: bez-vitaly@yandex.ru
197022, St. Petersburg, ul. Leo Tolstoy, 6-8.
Buzand V. Arakelyan, MD, professor of the Department of Obstetrics, Gynecology and Neonatology FSBEI HE “First St. Petersburg State Medical University named after Academician I.P. Pavlov Ministry of Health of the Russian Federation. Tel.: + 7(812) 338 7866, e-mail: byuzand@mail.ru
197022, St. Petersburg, ul. Leo Tolstoy, 6-8.
Victor A. Linde, MD, professor of the Department of Obstetrics, Gynecology and Reproductology, professor of the Department of Obstetrics, Gynecology and Neonatology FSBEI HE “First St. Petersburg State Medical University named after academician I.P. Pavlov Ministry of Health of the Russian Federation; obstetrician-gynecologist to
St. Petersburg State Budgetary Institution of Healthcare «City Alexander Hospital».
Tel. + 7(812)338-7866, e-mail: vik-linde@yandex.ru
197022, St. Petersburg, ul. Leo Tolstoy, 6-8.
Karina A. Gabelova, candidate of medical sciences, associate professor of the department of obstetrics, gynecology and neonatology; Head of the Obstetrics Department of Pregnancy Pathology, Clinic for Obstetrics and Gynecology, FSBEI HE “First St. Petersburg State Medical University named after Academician I.P. Pavlov Ministry of Health of the Russian Federation. Tel.: +7 (812)338-7866, e-mail: kgabelova@mail.ru
197022, St. Petersburg, ul. Leo Tolstoy, 6-8.
Oleg L. Molchanov, MD, professor of the Department of Obstetrics, Gynecology and Reproductology, professor of the Department of Obstetrics, Gynecology and Neonatology FSBEI HE “First St. Petersburg State Medical University named after academician I.P. Pavlov Ministry of Health of the Russian Federation.
Tel.: +7 (812) 338 7866, e-mail: moleg700@mail.ru
197022, St. Petersburg, ul. Leo Tolstoy, 6-8.

For citation: Ralnikova A.Yu., Bezhenar V.F., Arakelyan B.V., Linde V.A., Gabelova K.A., Molchanov O.L. Successful organ-sparing surgical treatment in a patient with the placenta previa growing into the uterine scar region.
Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2020;2: 183-9. (In Russian).
https://dx.doi.org/10.18565/aig.2020.2.183-189

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