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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 PDFPregnancy Outcomes After Transvaginal Radiofrequency Ablation of Leiomyomas.
Obstet Gynecol
January 2025
Division of Minimally Invasive Surgery, Victoria Rey Clinic, Loyola University, Seville, Spain.
Objective: To evaluate pregnancy outcomes after transvaginal radiofrequency ablation of leiomyomas.
Methods: We conducted a retrospective review of the medical records of 226 pregnant patients after transvaginal radiofrequency ablation of leiomyomas from January 1, 2017, to February 28, 2022.
Results: Patients' mean age was 37.
Urological injuries complicating pregnancy-related hysterectomy: Analysis of risk factors and proposal to improve the quality of care.
Eur J Obstet Gynecol Reprod Biol
January 2025
Obstetrics Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Purpose: While strategies aimed at preventing urological injuries complicating hysterectomy for gynaecological indications and placenta accreta surgery have been proposed, a comprehensive model for pregnancy-related hysterectomy (PRH) is lacking. The aim of this study was to investigate risk factors for urological complications of obstetric hysterectomy, and to propose strategies to improve the quality of care.
Methods: This retrospective study of patients undergoing PRH was conducted in an academic centre between 2009 and 2022.
PICC Lines in Pregnancy and Other Peripartum Vascular Access Considerations.
Obstet Gynecol Surv
January 2025
Professor, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC.
Importance: To decrease associated infectious and thrombotic morbidity, it is important to understand the indications and risks of peripherally inserted central catheters (PICCs) and other vascular access means in pregnancy.
Objectives: The objectives are 3-fold: (1) discuss indications and contraindications, approach to placement, and associated complications for PICC lines, arterial catheters, centrally inserted central catheters, and peripheral intravenous catheters; (2) review available data regarding complications associated with these catheters in pregnancy; and (3) propose an evidence-based approach to clinical decision making regarding vascular access in 2 clinical scenarios among pregnant patients.
Evidence Acquisition: A literature review identified relevant research, review articles, textbook chapters, databases, and societal guidelines, with a focus on obstetrical anesthesia and obstetric literature.
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.
J Matern Fetal Neonatal Med
December 2025
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.
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