Complex cesarean section: Surgical approach to reduce the risks of intraoperative complications and postpartum hemorrhage.

The incidence of cesarean section is dramatically increasing worldwide, whereas the training opportunities for obstetrician/gynecologists to manage complex cesarean section appear to be decreasing. This may be attributed to changing working hours directives and the increasing use of laparoscopy for gynecological surgical procedures, including in gynecological oncology. Various situations can create surgical difficulties during a cesarean section; however, two of the most frequent are complications from previous cesarean (myometrial defects, with or without placental intrusion and peritoneal adhesions) and the high risk of postpartum hemorrhage (uterine overdistension, abnormal placentation, uterine fibroids).

Telemedicine ultrasound assessment for placenta accreta spectrum: Utility and interobserver reliability of asynchronous remote imaging review.

Objective: Management of patients with placenta accreta spectrum (PAS) by trained multidisciplinary teams is associated with improved outcomes. Ultrasound can predict intraoperative risks, but expert ultrasound imaging of PAS is often limited. Telemedicine is used increasingly in obstetrics, permitting expert consultation when essential resources are not available locally.

[Uterine conservative treatment for placenta accreta : new standard?].

Placenta accreta spectrum (PAS) is among the most dangerous obstetric conditions due to elevated risk of massive hemorrhage. Ultrasound is PAS's preferred screening method. This article -introduces the new topographic classification of PAS, allowing for treatment selection, whether radical or conservative.