scholarly journals Penggunaan Skor Indeks Plasenta Akreta (IPA) sebagai Prediktor Manajemen Perioperatif Seksio Sesarea Pasien dengan Plasenta Previa Totalis Suspek Akreta

2020 ◽  
Vol 3 (2) ◽  
pp. 111-18
Author(s):  
Dadik Wahyu Wijaya ◽  
Yusmein Uyun ◽  
Sri Rahardjo
Keyword(s):  
Cesarean Section ◽  
Perioperative Management ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Stable Condition ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Hemoglobin Level ◽  
Elective Cesarean Section ◽  
Elective Cesarean

Plasenta akreta adalah suatu kondisi kehamilan yang serius yang disebabkan oleh kelainan perlekatan plasenta yang membutuhkan perhatian khusus secara perioperatif. Kasus ini menggambarkan manajemen anestesi yang sesuai untuk seksio sesarea dan total abdominal histerektomi karena  plasenta previa totalis dugaan akreta. Seorang wanita berusia 33 tahun dipersiapkan untuk menjalani seksio sesarea elektif dan histerektomi total akibat plasenta previa totalis dengan kecurigaan tinggi terhadap akreta berdasarkan Indeks Skor Plasenta Akreta (IPA). Pemeriksaan penunjang dilakukan oleh dokter kandungan untuk mengkonfirmasi diagnosis. Pada pasien ini dilakukan tindakan anestesi umum untuk prosedur operasinya. Kadar hemoglobin pasien sebelum operasi adalah 9,1 g / dl. Dengan total perdarahan selama operasi adalah 2000 mL. Estimasi kehilangan darah yang ditolerir untuk pasien ini adalah 633 ml. Pasien menerima transfusi 2(dua) kantong darah PRC dan 1(satu) kantong darah WB. Kadar hemoglobin setelah transfusi adalah 8,9 g / dL Pasien dipulangkan dari rumah sakit dalam kondisi stabil setelah dirawat selama 3 hari diruangan. Sebagai kesimpulan, evaluasi dan persiapan perioperatif dan kolaborasi multidisiplin adalah kunci keberhasilan manajemen pasien dengan plasenta previa suspek akreta.   The Use of Placenta Acreta Index (PAI) Score as Perioperative Management Predictor of Sectio Caesarean Patient with Total Placenta Previa Suspected Acreta Placenta accreta is a serious pregnancy condition caused by disorder of placenta attachment that needs a special consideration perioperatively. This case was described the propriate anesthesia management for Cesarean Section and Total Abdominal Hysterectomy due to Total Placenta Previa suspected Accreta. A 33 years old woman considered for elective cesarean section and hysterectomy due to Total Placenta Previa with high suspicion of Accreta according to Placenta Accreta Index (PAI) Score. Supportive examination was done by the obstetrician to confirm the diagnosis. She underwent general anesthesia for the surgery. Patient’s hemoglobin level before surgery was 9.1 g/dL. With total bleeding during the surgery is 2000 mL. The allowable blood loss for the patient is 633 mL. Patient was transfused with 2 bags of PRC and 1 bag of Whole Blood. The hemoglobin level after transfusion was 8.9 g/dL She was discharged from the hospital in stable condition after being treated for 3 days at normal ward. As conclusion, perioperative evaluation and preparations and multidiscipline collaboration are the key for successful management for patient with Placenta previa/accreta  

scholarly journals A Planned Cesarean Section-Hysterectomy For Placenta Previa Totalis Percreta In Patient With History Of Two Cesarean Sections

Medicinus ◽  
2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Julita Nainggolan
Keyword(s):  
Cesarean Section ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Health Resources ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Cesarean Sections ◽  
History Of ◽  
Rising Incidence ◽  
Previous Cesarean

<p><em>The presence of placenta previa may be associated with placenta accreta</em><em><sup>[1]</sup></em><em>.<sup>  </sup></em><em>Maternal and fetal morbidity and mortality from placenta previa accreta are considerable and are associated with high demands on health resources. With the rising incidence of caesarean sections combined with increasing maternal age, the number of cases of placenta praevia and its complications, including placenta accreta, will continue to increase</em><em><sup>[2]</sup></em><em>. </em><em>Here, we present a case of  placenta previa totalis percreta in previous cesarean section twice. In this case, patient with placenta previa totalis-percreta we diagnosed and prepared  proper management with the involvement of multidisciplinary team. We reduced blood loss by performing total abdominal hysterectomy immediately after delivered the baby and the postoperative course was uneventful.</em></p><p><strong><em>Keywords: Cesarean Section-Hysterectomy, placenta accreta, placenta percreta, placenta previa</em></strong></p>

scholarly journals A Planned Cesarean Section-Hysterectomy for Placenta Previa Totalis Percreta in Patient with History of Two Cesarean Sections

Medicinus ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 13
Author(s):  
Julita Nainggolan
Keyword(s):  
Cesarean Section ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Health Resources ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Cesarean Sections ◽  
History Of ◽  
Rising Incidence ◽  
Previous Cesarean

<p class="Default">The presence of placenta previa may be associated with placenta accreta<sup>[1]</sup>.<sup>  </sup>Maternal and fetal morbidity and mortality from placenta previa accreta are considerable and are associated with high demands on health resources. With the rising incidence of caesarean sections combined with increasing maternal age, the number of cases of placenta praevia and its complications, including placenta accreta, will continue to increase<sup>[2]</sup>. Here, we present a case of  placenta previa totalis percreta in previous cesarean section twice. In this case, patient with placenta previa totalis-percreta we diagnosed and prepared  proper management with the involvement of multidisciplinary team. We reduced blood loss by performing total abdominal hysterectomy immediately after delivered the baby and the postoperative course was uneventful.<strong></strong></p>

Successful Conservative Management of Recurrent Focal Placenta Accreta, A Case Study

2017 ◽  
Vol 9 (3) ◽  
Author(s):  
AlSaif Batool ◽  
Aljarrash Majeda
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Fetal Outcome ◽  
Elective Cesarean Section ◽  
Mortality And Morbidity ◽  
Uterine Anomalies ◽  
Elective Cesarean ◽  
Almost All

Placenta accreta refers to an abnormality of placental implantation in which the anchoring placental villi attach to myometrium rather than decidua, resulting in a morbidly adherent placenta . It is a life-threatening diagnosis increasing in number due to the growing number of caesarean sections. For most patients, the method of choice is elective cesarean section followed by hysterectomy. For women who wish to preserve fertility, a conservative procedure may be considered. Almost all reported cases have known major risk factors which are previous caesarean section , current placenta previa , previous uterine surgery and known uterine anomalies .We report here an extremely rare case of recurrent focal placental accreta in 35 years old Saudi female, G3P2+0. 39 weeks pregnant, previous 1 cesarean section, breech with current focal accreta discovered late at 38wk +.Our case doesn’t have known major or even controversial minor risk factors in her 1st accreta.Risk factors for the second accreta were previous focal accreta at fundus and previous 1. In addition this is a successful uterine conservation for the 2nd time with no complications apart from mild bleeding of 2 liters- (the average usual bleeding is 6100 ). known complications for placental accreta include:Severe vaginal bleeding: 53 %, Sepsis: 6%, Secondary hysterectomy: 19% , death: 0.3 % 1 .Cesarean-hysterectomy is the best management of placenta accreta because it has reduced mortality and morbidity as well as injuries to nearby organs and hospital stay. It is important to report this case in order to keep in mind screening for suspicious of placenta accreta during perinatal US even if the patient has no risk factors in order to have planned delivery which will improve the mother and fetal outcome including most importantly decreasing the mortality rate due to postpartum hemorrhage and will increase the likelihood of successful uterine conservation especially in low parity patient.

scholarly journals Conservative Surgical Treatment of a Case of Placenta Accreta

2018 ◽  
Vol 40 (08) ◽  
pp. 494-496 ◽  
Author(s):  
Ismail Biyik ◽  
Fatih Keskin ◽  
Elif Keskin
Keyword(s):  
Cesarean Section ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Placental Tissue ◽  
Uterine Wall ◽  
Elective Cesarean Section ◽  
Triple P ◽  
Cesarean Hysterectomy ◽  
Uterine Incision ◽  
Fertility Sparing

AbstractPlacenta accreta syndromes are associated with increased maternal mortality and morbidity. Cesarean hysterectomy is usually performed in cases of placenta accreta syndrome. Fertility sparing methods can be applied. In the present study, we report a successful segmental uterine resection method for placenta accreta in the anterior uterine wall in a cesarean section case. A 39-year-old woman underwent an elective cesarean section at 38 + 2 weeks. A placental tissue with an area of 10 cm was observed extending from the anterior uterine wall to the serosa, 2 cm above the uterine incision line. The placental tissue was removed with the help of monopolar electrocautery. The uterine incision was continuously sutured. The patient was discharged on the second postoperative day. The placental pathology was reported as placenta accreta. The American College of Obstetricians and Gynecologists (ACOG) generally recommends cesarean section hysterectomy in cases of placenta accreta because removal of placenta associated with significant hemorrhage. Conservative and fertility sparing methods include placenta left in situ, cervical inversion technique and triple-P procedure. There are several studies reporting that segmental uterine resection is performed with and without balloon placement or artery ligation. Segmental uterine resection may be an alternative to cesarean hysterectomy to preserve fertility or to protect the uterus in cases of placenta accreta when there is no placenta previa.

Perioperative management of a case of peripartum cardiomyopathy for elective cesarean section

2021 ◽  
Vol 10 (3) ◽  
pp. 235
Author(s):  
Shalendra Singh ◽  
Nitesh Kumar ◽  
GeorgeCherian Ambooken ◽  
Shibu Sasidharan ◽  
Priya Taank
Keyword(s):  
Cesarean Section ◽  
Perioperative Management ◽  
Peripartum Cardiomyopathy ◽  
Elective Cesarean Section ◽  
Elective Cesarean

scholarly journals PLACENTA PREVIA;

2019 ◽  
Vol 26 (03) ◽  
Author(s):  
IFAT BALOCH ◽  
Naseem Bajari ◽  
Sabrina Talpur ◽  
Saima Naz Shaikh
Keyword(s):  
Cesarean Section ◽  
Placenta Previa ◽  
Tertiary Care ◽  
University Hospital ◽  
Elective Cesarean Section ◽  
Care Hospital ◽  
Obstetric Hemorrhage ◽  
Emergency Cesarean ◽  
Precise Diagnosis ◽  
Elective Cesarean

Objectives: To determine the maternal and fetal outcomes in patients presented with major degree of placenta previa at tertiary care Hospital. Study Design: Descriptive cases series study. Setting: Department of Gynaecology and Obstetrics of Liaquat University Hospital Hyderabad. Period: One year from March 2015 to February 2016. Subject and Methods: All patients with major degrees of placenta previa were included in study. Following delivery the examination of neonate was carried out thoroughly including congenital abnormalities, weight of baby and Apgar score. Babies and mothers were examined within postoperative wards till stitches removal and systematically examined for any postoperative complication. All the data was entered in the proforma. Results: Total 50 patients with major degrees of placenta previa were selected. Majority of the women 40% belonged to the age group of 30-35 years. Most of the women 92.0%, were symptomatic and presented with painless vaginal bleeding. Elective cesarean section was performed among 20% patients while 80% patients underwent emergency cesarean section. 70% patients delivered preterm and 30% delivered at term. 3(6%) fetals were still births and 1(2.0%) presented macerated still birth. 16% fetuses developed respiratory distress syndrome, 6% had intrauterine growth restriction and only one had congenital abnormality (spina bifida). Neonatal weight less than 2500-grams was among 90%. Perinatal mortality was 6(12.0%), and according to maternal outcome, mortality rate was low i.e. just 1 subjects passed away. Conclusion: Major degree of placenta previais a significant contributor of obstetric hemorrhage in 02nd and 03rd trimesterof pregnancy as well as it adversely correlates with feto-maternal outcomes. Instant moving the case of obstetric hemorrhage to hospitals, precise diagnosis, sufficient transfusion provision, intervention without delay can reduce the fetomaternal morbidity and mortality.

scholarly journals Sudden maternal hypoxemia during elective cesarean section in a woman with placenta previa

2017 ◽  
Vol 5 (10) ◽  
pp. 1668-1671
Author(s):  
Takeshi Umazume ◽  
Satoshi Hayasaka ◽  
Fumi Kato ◽  
Satoshi Ishikawa ◽  
Mamoru Morikawa ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Placenta Previa ◽  
Elective Cesarean Section ◽  
Elective Cesarean

scholarly journals BLOOD LOSS DURING EMERGENCY CAESAREAN SECTION OF PLACENTA PREVIA IS MORE AS COMPARED TO ELECTIVE CAESAREAN SECTION

2021 ◽  
Vol 31 (03) ◽  
pp. 146-150
Author(s):  
Sardar Muhammad Alfareed Zafar Zafar ◽  
Mehvish Ilyas ◽  
Saima Saeed Usmani ◽  
Maryam Javaid ◽  
Rizwana Tariq
Keyword(s):  
Caesarean Section ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Cesarean Section ◽  
Placenta Previa ◽  
Emergency Caesarean Section ◽  
Elective Cesarean Section ◽  
Emergency Caesarean ◽  
Elective Cesarean ◽  
The Mean

Background: Placenta Previa is one of the major obstetric complication. It is a serious condition that may lead to severe morbidity and mortality. The risk of cesarean and blood loss, particularly, in emergency cesarean section. Objective: To compare the mean blood loss and need for blood or blood products with emergency versus elective cesarean section in females with placenta previa. Study design: Cohort study. Settings: Department of Obstetrics & Gynaecology. Duration: 3 months (April to June 2020). Method: Sample size of 70 patients were enrolled in the study through Non Probability, Consecutive Sampling. Patients of age 20-40 years, presented >24 weeks of pregnancy, with diagnosis of placenta previa were included. Then females were booked and were followed-up in OPD till delivery. Emergency cesarean section was done if active labor and bleeding started while elective cesarean was done on given date for delivery. Intraoperative blood loss and need for blood or blood components transfusion was noted. Data was recorded on proforma and analyzed by using SPSS version 22. Results: The mean age of females in emergency group was 30.80 ± 4.36 years and mean age of females in elective group was 31.06 ± 3.76 years. The mean gestational age of females at delivery in emergency group was 35.74 ± 2.89 weeks and in elective group was37.54 ± 0.70 weeks. The average blood loss during emergency caesarean section was 1471.43 ± 891.65 ml while during elective cesarean section, average blood loss was 1042.86 ± 402.41 ml (p<0.05). In emergency caesarean group, 7 (20%) did not require blood transfusion while 28 (80%) required blood transfusion. In elective caesarean group, 21 (60%) did not require blood transfusion while 14 (40%) required blood transfusion (p<0.05). Conclusion: Though this study, we found significantly higher blood loss and need for blood transfusion in emergency caesarean section as compared to elective caesarean sections for placenta previa.

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