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Evaluation of a modified “Triple-P” procedure in women with morbidly adherent placenta after previous caesarean section

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Aim

To describe a modified “Triple-P” procedure and evaluate its outcome in women with morbidly adherent placenta (MAP) after previous caesarean section (CS).

Methods

A retrospective cohort study of 96 women with MAP after CS was recruited with 45 women receiving the modified “Triple-P” procedure as study group and the other 51 cases receiving the conventional managements as the control. The maternal outcomes were compared.

Results

The modified “Triple-P” procedure was described in step by step. Women in study group demonstrated reduction of blood loss, transfusion blood volume and operation time, as well as less hospital days and lower hospitalization cost (P < 0.05). In addition, there was no difference in uterine healing rate, hysterectomy rate, and ICU transferring rate (P > 0.05).

Conclusion

Our modified “Triple-P” procedure for MAP after previous CS maintained the advantages of Chandraharan’s “Triple-P” procedure in preservation of uterus for further fertility, less intraoperative blood loss, shorter hospital stays, and lower hospitalization cost but also advanced in feasibility and convenience during introducing into routine clinical practice.

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Acknowledgements

We thank the pregnant women and their families who participated in our study. Also thank the support from all staffs in the Department of Obstetrics and Gynecology, Nanfang Hospital, China. This research is supported by the Presidential Foundation of Nanfang Hospital for Young Scientists (2016C043).

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Ave North, 510515, Guangzhou, China

    Yanxing Wei, Yanwen Cao, Yanhong Yu & Zhijian Wang

  2. Department of Obstetrics and Gynecology, The First People’s Hospital of Chenzhou, 423001, Chenzhou, China

    Yanwen Cao

Authors
  1. Yanxing Wei
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  2. Yanwen Cao
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  3. Yanhong Yu
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  4. Zhijian Wang
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Contributions

YX Wei data analysis and manuscript writing. YW Cao data collection. YH Yu data analysis. ZJ Wang project development and data analysis

Corresponding author

Correspondence to Zhijian Wang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study has ethical approval by the Hospital Ethics Committee of Nanfang Hospital for the use of anonymized patient data for medical research.

Electronic supplementary material

Below is the link to the electronic supplementary material.

404_2017_4447_MOESM1_ESM.tif

Figure S1 Diagnosis and appearance of adherent placenta in patient A. A. Placenta adhering to the anterior and posterior uterine wall in ultrasound with Color Doppler. B. Hypervasculization surrounding the uterine anterior wall and placenta in Color Doppler. C. Placenta location with MRI. D. Adherent placenta vision after laparotomy (TIFF 43138 kb)

404_2017_4447_MOESM2_ESM.tif

Figure S2 Pathological findings of resected uterine tissue. A–D. Invasion of trophoblasts and villous tissue into the muscular layers (TIFF 42213 kb)

Supplementary material 3 (M4V 477986 kb)

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Wei, Y., Cao, Y., Yu, Y. et al. Evaluation of a modified “Triple-P” procedure in women with morbidly adherent placenta after previous caesarean section. Arch Gynecol Obstet 296, 737–743 (2017). https://doi.org/10.1007/s00404-017-4447-0

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  • DOI: https://doi.org/10.1007/s00404-017-4447-0

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