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Triple P with T-shaped lower segment suture; an effective novel alternative to hysterectomy in morbidly adherent anterior placenta previa
- Source :
- The Journal of Maternal-Fetal & Neonatal Medicine. 34:3187-3191
- Publication Year :
- 2019
- Publisher :
- Informa UK Limited, 2019.
-
Abstract
- To evaluate the efficacy and safety of the Triple-P procedure as a conservative method in women with morbidly adherent placenta (MAP).A prospective trial conducted on 20 women performing elective cesarean sections (CS) at 37 weeks for anterior placenta previa accreta or increta. All women were young aged with low parity and previous CS deliveries. Triple-P procedure involved delivery of the fetus through a uterine incision placed above the upper border of the placenta, bilateral uterine arteries ligation immediately after delivery of the fetus followed by placental nonseparation and myometrial excision with reconstruction of the uterine wall in a T-shaped manner. The study outcome measures included duration of surgery, amount of intra and postoperative blood loss, Percentage of hemoglobin (Hb %) reduction, the need to perform hysterectomy and postoperative complications.Mean duration of surgery was 58 ± 1.8 min, mean intraoperative blood loss was 1.3 ± 0.3 l, mean postoperative blood loss was 180 ± 94 ml and mean Hb % reduction was 1.5 ± 0.1 g/dl. Only one case necessitated hysterectomy for severe bleeding.Triple-P procedure is a novel effective weapon that can replace hysterectomy in suitable women with MAP, especially in young patients with low parity.
- Subjects :
- medicine.medical_specialty
Morbidly adherent placenta
Placenta
medicine.medical_treatment
Placenta Previa
Placenta Accreta
Hysterectomy
03 medical and health sciences
0302 clinical medicine
Suture (anatomy)
Pregnancy
medicine
Humans
Prospective Studies
030212 general & internal medicine
Aged
030219 obstetrics & reproductive medicine
Sutures
business.industry
Postpartum Hemorrhage
Obstetrics and Gynecology
medicine.disease
Placenta previa
Surgery
Prospective trial
Pediatrics, Perinatology and Child Health
Female
business
Subjects
Details
- ISSN :
- 14764954 and 14767058
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- The Journal of Maternal-Fetal & Neonatal Medicine
- Accession number :
- edsair.doi.dedup.....1bc41da25a80091d7f9be7911bb98f2d