Surrounding resection technique for placenta percreta: A fertility preserving approach

Yıl 2017, Cilt: 48 Sayı: 4, 180 - 182, 13.12.2017

Murat Ekin Cihan Kaya , Gülşen Akyıldız Levent Yaşar

https://doi.org/10.16948/zktipb.270306

Öz

Placenta percreta is a life-threatening obstetric emergency
characterized by the abnormal invasion of chorionic villi into the uterine
wall.
It is associated with significant maternal morbidity and mortality. Although various
conservative treatment modalities have been described, hysterectomy is still a common
option as life saving procedure. In this case, surrounding resection technique with
hypogastric artery ligation is described as an option in selected cases who
desire fertility.

Anahtar Kelimeler

fertility preservation, obstetric surgical procedure, placenta percreta

Plasenta perkretada çevresel rezeksiyon tekniği: bir fertilite koruyucu yaklaşım

Öz

Giriş: Plasenta perkreta koryonik villusların uterin duvara anormal
invazyonu ile karakterize yaşamı tehdit eden bir obstetrik acildir. Her nekadar
çeşitli konservatif tedavi seçenekleri tanımlanmış olsa da, histerektomi hala yaygın
olarak hayat kurtarıcı bir seçenek olarak bulunmaktadır.

Olgu: Bu olguda, fertilite isteği olan seçilmiş olgularda hipogastrik
arter bağlanmasıyla birlikte çevresel rezeksiyon tekniği tanımlanmıştır.

Sonuç: Fokal plasenta perkretalı seçilmiş olgularda deneyimli bir
cerrahi ekibi tarafından çevresel rezeksiyon tekniği kullanılabilir.

Anahtar Kelimeler

Fertilite koruma, obstetrik cerrahi prosedür, plasenta perkreta

Kaynakça

• 1. Khan M, Sachdeva P, Arora R, Bhasin S. Conservative management of morbidly adherant placenta A case report and review of literature. Placenta 2013;34: 963-66.
• 2. Narang L, Chandraharan E. Management of morbidly adherent placenta. Obstet Gynaecol and Reprod Med 2013;23:214-9.
• 3. Doumouchtsis SK, Arulkumaran S. Morbidly adherent placenta. Obstetrics. Gynaecol Reprod Med 2010; 20: 272-7.
• 4. Meyer NP, H Ward G, Chandraharan E. Conservative approach to themanagement of morbidly adherent placentae. Ceylon Med J 2011; 57:36-9.
• 5. Timmermans S, van Hof AC, Duvelot JJ. Conservative management of abnormally invasive placentation. Obstet Gynecol Surv 2007; 62:529-39.
• 6. Bodner LJ, Nosher JL, Gribbin C, Siegel RL, Beale S, Scorza W. Balloon-assisted occlusion of the internal iliac arteries in patients with placenta accreta/percreta. Cardiovasc Intervent Radiol 2006; 29: 354-61.
• 7. Arulkumaran S, Ng CS, Ingemasson I, Ratnam SS. Medical treatment of placenta accreta with methotrexate. Acta Obstet Gynecol Scand 1986; 65: 285-6.
• 8. Chandraharan E, Rao S, Belli A-M, Arulkumaran S. The Triple-P procedure as a conservative surgical alternative to peripartum hysterectomy for placenta percreta. Int J Obstet Gynecol 2012; 117: 191-4.
• 9. Chandraharan E. Should the Triple-P procedure be used as an alternative to peripartum hysterectomy in the surgical management of placenta percreta? Women’s Health 2012; 8: 1-3.