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Focal Resection of Lower Uterine Segment for Morbidly Adherent Placenta. An Alternative to Obstetric Hysterectomy-(Better Modality with Better Outcome).
- Source :
-
Pakistan Armed Forces Medical Journal . 4/30/2022, Vol. 72 Issue 2, p627-631. 5p. - Publication Year :
- 2022
-
Abstract
- Objectives: To focus on the benefits of focal resection of the lower uterine segment as compared to obstetric hysterectomy in patients with morbidly adherent placenta. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital Okara, Oct 2019 to Nov 2020. Methodology: Fifty-two women between 34 to 38 weeks of gestation were operated for morbidly adherent placenta. Group-I women (focal resection of the lower uterine segment) and Group-II (obstetric hysterectomy) were twenty-six each. In Group-I, hemostasis was secured by a figure of 8 sutures, purse-string sutures or continuous sutures. In Group-II, hemostasis was secured, and internal iliac artery ligation was done as required. Results: Group-I undergoing focal resection of lower uterine segment hemostasis was addressed by the figure of 8 sutures in 21 (80%) women and purse-string sutures in 7 women (27%). Hemostasis of the posterior uterine wall was done in 12 (47%) women. Balloon tamponade was used in 10 (40%) women and B-Lynch suture in 5 (20%) women. Internal iliac artery ligation was done in 4 (11%) women, and the bladder was injured in 10 (40%) women. Group-II undergoing obstetric hysterectomy hemostasis was secured for leftover placental tissue in 5 (18%) women, and internal iliac artery ligation was done in 9 (35%) women. Bladder repair was done in 12 (47%) cases. Conclusion: Although time-consuming, focal resection of the lower uterine segment and hemostasis are associated with less morbidity. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PLACENTA accreta
*ILIAC artery
*PLACENTA praevia
*MILITARY hospitals
Subjects
Details
- Language :
- English
- ISSN :
- 00309648
- Volume :
- 72
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Pakistan Armed Forces Medical Journal
- Publication Type :
- Academic Journal
- Accession number :
- 157247919
- Full Text :
- https://doi.org/10.51253/pafmj.v72i2.5780