Background: Peripartum hysterectomy is performed for a variety of indications, including abnormal placentation, retained placenta, uterine rupture, and uterine atony. Most cases are emergent and performed through open laparotomy.
Case: At 20 weeks of gestation, a patient with previous endometrial ablation had ruptured membranes and delivered her fetus but not her placenta. She was hemodynamically stable and underwent robotic hysterectomy. Surgical pathology confirmed placenta increta.
Conclusion: In appropriate patients, a minimally invasive approach may be considered for peripartum hysterectomy to potentially decrease maternal morbidity.
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Preoperative ultrasound risk factors for peripartum hysterectomy among PAS suspected pregnancies.
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Department of Obstetrics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No.1617, Riyue Avenue, Chengdu, Sichuan, 610091, China.
Objective: This study aimed to identify risk factors for peripartum hysterectomy among pregnancies complicated by suspected Placenta Accreta Spectrum (PAS) in preoperative obstetric imaging screening.
Methods: Data were retrospectively extracted from the Longitudinal Placenta Accreta Spectrum Study (LoPASS), covering pregnancies with PAS from January 2018 to March 2023 at our institute. Patients were divided into Control and Hysterectomy groups based on whether they underwent hysterectomy.
Effectiveness of the Triple P Procedure and its modifications on reducing the blood loss and peripartum hysterectomy rates in women with Placenta Accreta Spectrum (PAS): a review of published literature.
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Director of Global Academy of Medical Education & Training, London, UK.
Background: Placenta Accreta Spectrum (PAS) disorders has been reported to be associated with a maternal mortality rate of 7-10%, worldwide, and many women who survive, experience life changing morbidity. Triple P procedure (- perioperative placental localization and incision on the myometrium above the upper border of the placenta; - pelvic devascularisation; and -placental non-separation and myometrial excision) was developed in 2010 as a novel conservative alternative to peripartum hysterectomy to avoid severe maternal morbidity and mortality). There have been several modifications to the original Triple P Procedure to achieve "pelvic devascularisation" based on locally available resources.
View Article and Find Full Text PDFUnexpected placenta accreta spectrum in an unscarred uterus causing catastrophic post-partum hemorrhage: a case report and review of the literature.
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Department of Obstetrics and Gynaecology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, 151001, India.
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View Article and Find Full Text PDFTranscriptomic analysis identified novel biomarker in invasive placenta accreta spectrum.
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Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, 100191, China; State Key Laboratory of Female Fertility Promotion, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China. Electronic address:
Article Synopsis
- - Placenta accreta spectrum (PAS) disorders significantly endanger maternal health due to risks of severe bleeding and the necessity for hysterectomy, highlighting the need for reliable biomarkers.
- - This study identified miR-23a-5p as a potentially valuable biomarker for PAS through RNA-seq and qRT-PCR analysis, showing it is down-regulated in PAS cases while its target genes ASF1B and CHTF8 are up-regulated.
- - Combining miR-23a-5p with CHTF8 enhances diagnostic accuracy for PAS and related adverse outcomes, with improved AUC values suggesting their effectiveness as novel biomarkers.
We present a rare case report of a patient with a congenital uterine anomaly - uterus didelphys. Who spontaneously became pregnant and completed the pregnancy successfully after peripartum hysterectomy of one uterus. The reason for the peripartum hysterectomy was a life-threatening hemorrhage with hemoperitoneum after cesarean delivery.
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