Important surgical measures and techniques at cesarean hysterectomy for placenta previa accreta

作者：Matsubara Shigeki^*; Kuwata Tomoyuki; Usui Rie; Watanabe Takashi; Izumi Akio; Ohkuchi Akihide; Suzuki Mitsuaki; Nakata Manabu

来源：Acta Obstetricia et Gynecologica Scandinavica, 2013, 92(4): 372-377.

DOI：10.1111/aogs.12074

• Cesarean hysterectomy
• cesarean section
• ligation
• placenta accrete
• placenta previa

For cesarean hysterectomy with placenta previa accreta, universally achievable measures are required. We propose eight measures: (i) placement of intra-iliac arterial occlusion balloon catheters; (ii) placement of ureter stents; (iii) holding the cervix to identify the site to be transected; (iv) uterine fundal incision; (v) avoidance of uterotonics; (vi) M cross double ligation for ligating the ovarian ligament; (vii) filling the bladder to identify the bladder separation site and opening the bladder for placenta previa accreta with bladder invasion; and (viii) to continue to clamp the medial side of the parametrium or the cervix or employment of the double edge pick-up to ligate it. These eight measures are simple, easy, effective, and thus universally achievable.

• 出版日期2013-4