E-ISSN: 2149-9330
Management of Placenta Invasion Anomaly and Cesarean Hysterectomy: Eight-year Experience of A Tertiary Center
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Clinical Investigation
VOLUME: 10 ISSUE: 3
P: 143-150
September 2013

Management of Placenta Invasion Anomaly and Cesarean Hysterectomy: Eight-year Experience of A Tertiary Center

Turk J Obstet Gynecol 2013;10(3):143-150
DOI: 10.5505/tjod.2013.10692
İbrahim Kalelioğllu 1
Aytül Çorbacıoğlu Esmer 1
Recep Has 1
Halime Çalı 1
Tülay Özkan Seyhan 2
Mukadder Orhan Sungur 2
Yusuf Kılıç 1
1. Department Of Obstetrics And Gynecology, Istanbul University Istanbul Faculty Of Medicine, Istanbul
2. Department Of Anesthesiology, Istanbul University Istanbul Faculty Of Medicine, Istanbul, Turkey
No information available.
No information available
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ABSTRACT

Conclusion:

The incidence of placenta invasion anomaly is increasing progressively. Cesarean hysterectomy being its classical treatment is an operation with a high risk of morbidity and it should be performed by experienced teams after appropriate preparations in tertiary centers where multidiciplinary approach is possible.

Results:

In this period a total of 85 patients underwent cesarean hysterectomy. 81 (95.3%) cases had experienced at least one cesarean delivery before. Majority of the operations (82.4%) were performed in elective conditions. In 16 (18.8%) cases bilateral hypogastric artery ligation was carried out because of profuse bleeding. There were no mortalities in the intra- or postoperative period. In 18 (21.2%) cases, intraoperative urology consultation was needed. Full- thickness bladder laceration occured in 17 patients, and partial cyctectomy was performed in one patient due to the placenta percreata invading posterior wall of the bladder. Transfusion was needed in 72 (84.7%) cases during and 50 (58.8%) patients after operation. Dilutional trombocytopenia developed in 17 (20%) patients due to massive transfusion. Histopathologically the diganosis was placenta accreata in 55 (64.7%), placenta increata in 1 (1.2%) and placenta percreata in 25 (29.4%) patients. The incidence of placenta invasion anomaly rose from 0.2% (7/3435) in 2005-2006 up to 0.8% (37/4344) in 2011-2012.

Methods:

In this retropective study, the charts of all patients who underwent cesarean hysterectomy with an indication of placenta invasion anomaly in Istanbul Faculty of Medicine Department of Obstetrics and Gynecology between 2005 and 2012 were reviewed.

Objective:

We aimed to present our experience with the management of placenta invasion anomaly by reviewing clinical and operative features of the cases of cesarean hysterectomy performed due to placenta invasion anomaly.