4.5 Article

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

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WILEY-BLACKWELL
DOI: 10.1111/aogs.12074

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

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  1. Grants-in-Aid for Scientific Research [24592482] Funding Source: KAKEN

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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.

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