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Surgical management of 58 patients with placenta praevia percreta

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Summary

Objective

The aim of this study is to present our experience with surgical management of placenta praevia percreta.

Methods

This study was conducted from January 2009 through March 2014 at Harran University Hospital and was a chart review of all patients who underwent caesarean hysterectomy with the placenta left in situ for placenta praevia percreta.

Results

The study group comprised 58 patients. All of the patients underwent ultrasound mapping of the placental area before surgery. Emergent caesarean hysterectomy was only performed in 9 patients; 49 patients underwent planned caesarean hysterectomy. Bilateral internal iliac artery ligation was performed in all cases. Four patients (6.9 %) had bladder damage, one patient (1.7 %) required cystotomy, and one patient (1.7 %) required re-operation because of postoperative hemorrhage. The mean operative time was 141.6 (range: 95–355) minutes. Only 17 (29.3 %) patients were administered more than four units of red blood cells. There was no ureteral damage or maternal death. Furthermore, there were no complications in 42 (72.4 %) patients.

Conclusions

Caesarean hysterectomy for placenta praevia percreta is associated with increased maternal morbidity. However, preoperative diagnosis of placenta praevia percreta, ultrasound mapping of the placenta, and the presence of a multidisciplinary experienced team may decrease maternal morbidity and mortality. Moreover, the urinary system may be protected in the patients with placenta praevia percreta without serious morbidity.

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Authors and Affiliations

  1. Department of Obstetrics & Gynaecology, School of Medicine, Mugla Sitki Kocman University, 48000, Mugla, Turkey

    Aysun Camuzcuoglu MD & Hakan Camuzcuoglu MD

  2. Department of Obstetrics & Gynaecology, Faculty of Medicine, Marmara University, Istanbul, Turkey

    Mehmet Vural MD

  3. Department of Obstetrics & Gynaecology, Harran University, Sanliurfa, Turkey

    Nese Gul Hilali MD & Adnan Incebiyik MD

  4. Department of Anesthesiology and Reanimation, Faculty of Medicine, Harran University, Sanliurfa, Turkey

    Hasan Husnu Yuce MD & Ahmet Kucuk MD

Authors
  1. Aysun Camuzcuoglu MD
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  2. Mehmet Vural MD
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  3. Nese Gul Hilali MD
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  4. Adnan Incebiyik MD
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  5. Hasan Husnu Yuce MD
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  6. Ahmet Kucuk MD
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  7. Hakan Camuzcuoglu MD
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Corresponding author

Correspondence to Aysun Camuzcuoglu MD.

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Conflict of interest

A. Camuzcuoglu, M. Vural, N. G. Hilali, A. Incebiyik, H. H. Yuce, A. Kucuk, and H. Camuzcuoglu declare that there are no actual or potential conflicts of interest in relation to this article. The authors alone are responsible for the content and writing of the paper.

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Camuzcuoglu, A., Vural, M., Hilali, N.G. et al. Surgical management of 58 patients with placenta praevia percreta. Wien Klin Wochenschr 128, 360–366 (2016). https://doi.org/10.1007/s00508-016-0962-4

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  • DOI: https://doi.org/10.1007/s00508-016-0962-4

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