A novel low uterine segment sandwich technique (Caliskan's technique) for the management of post-cesarean hemorrhage due to placenta previa accreta

Yükleniyor...
Küçük Resim

Tarih

2021

Dergi Başlığı

Dergi ISSN

Cilt Başlığı

Yayıncı

GALENOS YAYINCILIK

Erişim Hakkı

info:eu-repo/semantics/openAccess

Özet

Objective: Placenta previa (PP) and placenta accreta spectrum (PAS) disorders are major causes of postpartum hemorrhage (PPH). There is a variety of surgical management options with inexplicit reported success rates. Uterine sandwich is a combination of uterine compression sutures and intrauterine balloon placement to achieve hemostasis. The aim of this study was to present our experience of seven women managed with a novel "lower uterine sandwich" technique to control post-cesarean hemorrhage due to PP accreta. Materials and Methods: Seven pregnant women diagnosed as having PP totalis accreta underwent a post-cesarean procedure combining bilateral ligation of the uterine artery, utero-ovarian artery, and internal iliac artery, Pereira compression sutures implemented on the uterine isthmus, Foley catheter placement into the lower uterine segment, and transvaginal cervical cerclage application, namely "Caliskan's uterine sandwich technique". Results: All women included in this study had placental invasion abnormalities of varying degrees. Postoperative diffusion magnetic resonance imaging assessment revealed a completely normal and preserved uterine blood supply. All women menstruated regularly in their postoperative follow-up period and two women conceived again and delivered uneventfully. None of the patients experienced morbid complications nor required hysterectomy. Conclusion: This novel procedure appears to be a plausible fertility and organ-preserving option in cases of intractable PPH, particularly in lower uterine segment bleeding. This uterine sandwich technique may allow physicians to manage massive hemorrhage due to PAS conservatively by preserving the uterus and its functions without major complications.

Açıklama

Anahtar Kelimeler

Placenta Previa, Postpartum Hemorrhage, Uterine Sandwich Technique, Uterine Compression Suture

Kaynak

TURKISH JOURNAL OF OBSTETRICS AND GYNECOLOGY

WoS Q Değeri

N/A

Scopus Q Değeri

Q3

Cilt

18

Sayı

2

Künye

Çalışkan, E., Akar, B., Ceylan, Y., & Karadağ, C. (2021). A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of post-cesarean hemorrhage due to placenta previa accreta. Turkish Journal of Obstetrics and Gynecology, 18(2), 79-84.