Thrombosis after aortic balloon occlusion during cesarean delivery for abnormally invasive placenta

2018 ◽  
Vol 33 ◽  
pp. 32-39 ◽  
Author(s):  
F. Luo ◽  
Z. Wu ◽  
J. Mei ◽  
J. Yue ◽  
X. Yu ◽  
...  
2018 ◽  
pp. 19-24
Author(s):  
O.V. Golyanovskiy ◽  
◽  
V.V. Mekhedko ◽  
D.O. Goncharenko ◽  
V.M. Kucher ◽  
...  

The article presents a case from practice with prenatal diagnostics of abnormally invasive placenta (Рl. Percreta) with invasion into the back wall of the bladder on the background of full placenta previa and previous caesarean section. Stressed the relevance of modern diagnostic pathologists placentation using ultrasound, Doppler and MRI to determine the depth of invasion of the placental tissue into the myometrium is emphasized. An innovative algorithm for delivery of a pregnant woman with this severe pathology using the endovascular technique of temporary balloon occlusion of the abdominal aorta, performing a cesarean section with a subsequent hysterectomy without appendages, ligating of the internal iliac arteries (IIAL), and argon-plasma tissue coagulation is proposed. The proposed method significantly reduces the amount of blood loss, the likelihood of developing massive bleeding, coagulopathic disorders and possible damage to adjacent organs. Key words: abnormally invasive placenta, placenta increta/rercreta, placenta previa, massive obstetric hemorrhage, balloon occlusion of the aorta, argon-plasma tissue coagulation.


2018 ◽  
Vol 47 (1) ◽  
pp. 12-15 ◽  
Author(s):  
Thorsten Braun ◽  
Katharina Weizsäcker ◽  
Mustafa Zelal Muallem ◽  
Janina Tillinger ◽  
Larry Hinkson ◽  
...  

Abstract The number of pregnant women with abnormally invasive placenta (AIP) including clinical relevant placenta increta and percreta has markedly increased with a reported incidence of as high as one in 731, By 2020 in the United States, there will be an estimated 4504 new cases of AIP and 130 AIP-associated maternal deaths annually. The preoperative diagnosis and operative management of AIP is challenging. In a planned cesarean delivery, a vertical lower abdominal skin incision is widely used in order to have enough space to perform a hysterotomy above the cranial edge of the placenta to avoid significant fetal and/or maternal hemorrhage. We have used preoperative drainage of the amniotic fluid after epidural anesthesia and immediately before a planned cesarean delivery through a transverse skin incision in five patients with AIP of the anterior uterine wall. With less uterine volume, exteriorization of the gravid uterus is easily performed through a transverse laparotomy. The combination of amnion drainage, transverse laparotomy and exteriorization of the gravid uterus facilitates identification of the exact site of placental implantation, provides adequate space for performing fundal or high anterior or even posterior uterine wall incisions and to deliver the fetus safely while minimizing the risk of placental separation and subsequent uncontrolled blood loss. Furthermore, this technique provides the chance to leave the untouched placenta in situ or to remove the placenta in toto with a uterine wall segment.


Author(s):  
Igor M. Samokhvalov

Dear Readers, Welcome to the sixth edition of the JEVTM! In 1866, the Great Russian surgeon and scientist Nikolai Pirogov wrote: “A new era for surgery will begin, if we can quickly and surely control the flow in a major artery without exploration and ligation”. This era has now arrived and it is called EVTM! Our mission has been to maximize the benefits of endovascular technologies for trauma and bleeding patients: from the first attempts of REBOA by Carl Hughes in the 1950s with hand-made aortic balloon occlusion catheters used in our department since the early 1990s to modern successful cases of out-of-hospital REBOA use in combat and civilian casualties for ruptured aneurysms, post-partum hemorrhage and trauma. In this edition, you will find articles related to a new strategy of damage control interventional radiology (DCIR), partial REBOA in elderly patients and in ruptured aortic aneurysms, thrombolysis for trauma-associated IVC thrombosis, simulation models for training of REBOA, contemporary utilization of Zone III REBOA and more. As a continuation of EVTM development, Russian surgeons, emergency physicians, anesthetists, and others will be involved in the world of EVTM, participating in expanding the horizons of trauma care and cultivating the endovascular mindset. Also published in this edition are some of the abstracts that will be presented at the EVTM conference in Russia, St. Petersburg (7/06/2019). More than 35 oral and 30 poster presentations will make this conference a scientific feast for our audience! By adopting these new techniques for bleeding management, we are following Pirogov’s motto – to achieve fast endovascular hemorrhage control – which can only be done as part of an interdisciplinary approach.   We look forward to seeing you in Saint Petersburg at the EVTM-Russia meeting! www.evtm.org


2018 ◽  
Vol 51 (2) ◽  
pp. 184-188 ◽  
Author(s):  
G. Calì ◽  
F. Forlani ◽  
G. Minneci ◽  
F. Foti ◽  
S. Di Liberto ◽  
...  

2017 ◽  
Vol 96 (11) ◽  
pp. 1373-1381 ◽  
Author(s):  
Heather J. Baldwin ◽  
Jillian A. Patterson ◽  
Tanya A. Nippita ◽  
Siranda Torvaldsen ◽  
Ibinabo Ibiebele ◽  
...  

Diseases ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 56
Author(s):  
Ana Maria Cubo ◽  
Ana Villalba Yarza ◽  
Irene Gastaca ◽  
María Victoria Lapresa-Alcalde ◽  
Maria José Doyague ◽  
...  

An abnormally invasive placenta (AIP) is a placenta that cannot be removed spontaneously or manually without causing severe bleeding. It is a dangerous condition associated with a high rate of maternal and perinatal morbidity and mortality due to the high rate of massive bleeding and visceral injuries. The standardized ultrasound diagnostic criteria have helped improve its early diagnosis, which is essential to plan coordinated actions to reduce associated morbimortality. We present a case report in which ultrasound diagnosis played a decisive role, enabling the coordination of a multidisciplinary team and improving the immediate care of both mother and newborn. Cesarean hysterectomy was performed with minimal blood loss and a good postsurgical recovery.


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