A case of a cervico-isthmic pregnancy without abnormal location of placenta

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Hiroko Yoshida ◽  
Yasuyuki Fujita ◽  
Yasuo Yumoto ◽  
Nobuhiro Hidaka ◽  
Kotaro Fukushima ◽  
...  
Keyword(s):  
Uterine Cervix ◽  
Histopathological Examination ◽  
Placenta Previa ◽  
Massive Hemorrhage ◽  
Multiparous Woman ◽  
Placenta Increta ◽  
Careful Evaluation ◽  
Early Gestation ◽  
Cesarean Hysterectomy ◽  
Normal Site

AbstractCervico-isthmic pregnancies (CIP) are often complicated by massive hemorrhage due to placenta previa and adhesion. Herein, we present a case of CIP without placenta previa, complicated by cervical incompetency. A 39-year-old multiparous woman was diagnosed with CIP at 8 weeks. The placenta was located on the normal site, and no significant ultrasonographic findings were noted after 14 weeks. At 20 weeks, a cervical incompetency was complicated. A healthy infant was delivered by a cesarean hysterectomy at term. Histopathological examination confirmed CIP with placenta increta. In cases with CIP without placenta previa, the diagnosis during early gestation and careful evaluation of uterine cervix is essential to avoid severe complications.

scholarly journals Large myomas as a complicating factor necessitating cesarean myomectomy followed by cesarean hysterectomy

2018 ◽  
Vol 146 (7-8) ◽  
pp. 452-455
Author(s):  
Radmila Sparic ◽  
Nebojsa Radunovic ◽  
Andrea Tinelli ◽  
Olivera Radevic ◽  
Sasa Kadija
Keyword(s):  
Histopathological Examination ◽  
Massive Hemorrhage ◽  
Elective Cesarean Section ◽  
Term Pregnancy ◽  
Cesarean Hysterectomy ◽  
Uterine Myomas ◽  
Elective Cesarean ◽  
Cesarean Myomectomy ◽  
Large Hematoma ◽  
Intrapartum Hemorrhage

Introduction. Although uterine myomas are becoming more common in pregnancies due to advanced maternal age, the literature lacks reports on complications, such as hysterectomy following cesarean myomectomy (CM). The aim of this work was to describe when CM is inevitable, complicated by severe intrapartum hemorrhage and requiring a hysterectomy. Case outline. A pregnant, with a term pregnancy and large multiple myomas, was referred for elective cesarean section (CS). During the CS, forced enucleation of a 100 mm anterior and left myoma previa (pre-fetal extraction) was necessary, and a 2,800 g neonate was delivered through the lower uterine segment incision. After the delivery and another CM, it was necessary to stop a massive hemorrhage from the myometrial myoma bed. Following provisory suturings of the hysterotomies, an urgent hysterectomy was performed with left salpingo-oophorectomy, due to a large hematoma in the left retroperitoneal space. The patient?s further recovery was uneventful and she was discharged with her baby on the sixth postoperative day. The histopathology report revealed a 135 ? 190 ? 150 mm uterus, weighing together with the enucleated myomas and left adnexa 5,000 g in total. The weight of the enucleated myomas was 1,670 g. The histopathological examination also showed 12 intramural and subserous myomas in the myometrium, ranging 30?190 mm. Conclusion. Large myomas, especially previa, may present a serious problem for fetal extraction during a CS. Therefore, the authors suggest an informed consent for CM, in patients who should undergo a CS. Additionally, such patients should be counseled about the possibility of an intrapartum hysterectomy.

scholarly journals Cesarean Section for Placenta Previa and Placenta Previa Accreta Spectrum

2020 ◽  
Vol 06 (S 02) ◽  
pp. S110-S121
Author(s):  
Satoru Takeda ◽  
Jun Takeda ◽  
Shintaro Makino
Keyword(s):  
Cesarean Section ◽  
Disseminated Intravascular Coagulation ◽  
Placenta Previa ◽  
Massive Hemorrhage ◽  
Intravascular Coagulation ◽  
Cesarean Hysterectomy ◽  
Separation Surface ◽  
Life Saving

AbstractAccording to the increase in the rate of cesarean section and the increase of high-aged pregnancy, we seem to more often encounter cases with placenta previa and placenta previa accrete spectrum. There are concerns about these cases, such as difficulty in controlling bleeding from the separation surface of placenta previa, the need for hysterectomy as a life-saving procedure, systemic management and hemostasis during massive hemorrhage, and treatment of disseminated intravascular coagulation (DIC). These cases are most frequently associated with cesarean hysterectomy.

scholarly journals Placenta increta presenting with threatened miscarriage during the first trimester in rhesus-negative mother: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Nik Lah Nik-Ahmad-Zuky ◽  
Azmel Seoparjoo ◽  
Engku Ismail Engku Husna
Keyword(s):  
Placenta Accreta ◽  
Histopathological Examination ◽  
Placenta Previa ◽  
Major Complication ◽  
First Trimester ◽  
Management Plan ◽  
Placenta Increta ◽  
Threatened Miscarriage ◽  
History Of ◽  
Previous Cesarean

Abstract Background Placenta accreta is known to be associated with significant maternal morbidity and mortality—primarily due to intractable bleeding during abortion or delivery at any level of gestation. The complications could be reduced if placenta accreta is suspected in a patient with a history of previous cesarean delivery and the gestational sac/placenta is located at the lower part of the uterus. Then, a proper management plan can be instituted, and complications can be reduced. The diagnosis of placenta accreta in the first trimester of pregnancy is considered uncommon. Case presentation A 34-year-old Malay, gravida 4, para 3, rhesus-negative woman was referred from a private hospital at 13 weeks owing to accreta suspicion for further management. She has a history of three previous lower-segment cesarean sections. She also had per vaginal bleeding in the early first trimester, which is considered to indicate threatened miscarriage. Transabdominal ultrasound revealed features consistent with placenta accreta spectrum. She was counseled for open laparotomy and hysterectomy because of potential major complication if she continued with the pregnancy. Histopathological examination revealed placenta increta. Conclusion A high index of suspicion of placenta previa accreta must be in practice in a patient with a history of previous cesarean deliveries and low-lying placenta upon ultrasound examination during early gestation.

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