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Contrast-Enhanced Ultrasound Diagnosis of Uterine Myometrial Ischemia Following Myometrial Repair Sutures for Postpartum Hemorrhage Caused by Placenta Accreta.
J Clin Ultrasound
January 2025
Department of Ultrasonic Medicine, West China Second University Hospital of Sichuan University, Chengdu, China.
We report the case of a 28-year-old female patient (gravida 2, para 1) who underwent a cesarean section after 33 weeks of pregnancy due to severe preeclampsia. The placenta was deeply embedded in the myometrium. Localized myometrial ischemia occurred following repair and suturing of the myometrium at the placental attachment site.
View Article and Find Full Text PDFUp-front dissection of the uterovesical space or "bladder-first approach" reduces hemorrhage and bladder injury during hysterectomy for placenta accreta spectrum: reconfirmed in 78 more cases in a prospective single-center study.
AJOG Glob Rep
February 2025
Urology (Mavuduru), Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Background: Cesarean hysterectomy for placenta accreta spectrum disorder may be associated with severe hemorrhage because of placental invasion of the myometrium and the uterovesical space or parametrium. It leads to serious complications, such as massive hemorrhage requiring massive transfusion, coagulopathy, bladder and ureteric injuries, need for intensive care unit admission and prolonged hospital stay. To reduce the complications of cesarean hysterectomy for placenta accreta spectrum disorder, ongoing efforts are being made to develop different surgical approaches.
View Article and Find Full Text PDFComplex cesarean section: Surgical approach to reduce the risks of intraoperative complications and postpartum hemorrhage.
Int J Gynaecol Obstet
January 2025
FIGO, London, UK.
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).
View Article and Find Full Text PDFEvaluation of single-layer versus double-layer suturing of low transverse uterine incisions in cesarean section and follow-up of scars by ultrasound: a prospective randomized controlled study.
Turk J Med Sci
December 2024
Department of Obstetrics and Gynecology, Faculty of Medicine, Gazi University, Ankara, Turkiye.
Background/aim: Cesarean section (CS) is a widely performed operation worldwide but data about uterine closure are lacking. We aimed to evaluate scar niches and compare single-layer and double-layer uterine closure at 6 months following CS.
Materials And Methods: This prospective randomized trial assessed 56 women undergoing single- or double-layer uterine closure.
Proof of concept testing of a vascular closure device for use in fetal surgery.
J Matern Fetal Neonatal Med
December 2025
University of Cincinnati Medical College of Medicine, Cincinnati, OH, USA.
Objective: Prior clinical findings have demonstrated that maternal laparotomy with trans-amniotic trans-uterine suturing of the fetoscopic port site during in utero myelomeningocele repair reduces the risk of membrane rupture. However, due to laparotomy-associated morbidity, we aimed to explore the feasibility of using a vascular closure device for percutaneous trans-amniotic trans-uterine suturing.
Methods: This IRB and IACUC-exempt study utilized 2 strategies for proof-of-concept testing of using the Abbott Perclose ProStyle Device for suture placement; 1.
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