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KMID : 0358420140570050397
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Korean Journal of Obstetrics and Gynecology
2014 Volume.57 No. 5 p.397 ~ p.400
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Placenta percreta with a vaginal fistula after successful management by uterine transverse fundal incision and subsequent cesarean hysterectomy
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Matsuzaki Satoko
Matsuzaki Shinya
Ueda Yutaka
Egawa-Takata Tomomi
Mimura Kazuya
Kanagawa Takeshi
Morii Eiichi
Kimura Tadashi
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Abstract
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Placenta previa presents a highest risk to pregnancy, and placenta accreta is the most serious. Placenta accreta requires cesarean delivery and often results in massive obstetric hemorrhage and higher maternal morbidity. Challenges associated with cesarean delivery techniques may contribute to increased maternal blood loss and morbidity rates. Several recent obstetric studies reported the usefulness of transverse uterine fundal incision for managing placenta accreta. We present a case of placenta percreta that was treated by a transverse fundal incision. We successfully avoided cutting through the placenta and helped decrease maternal blood loss. After delivery, the patient underwent a cesarean hysterectomy. Postoperative day 48, she experienced watery discharge and was diagnosed with vaginal fistula. We present our case and review the literature.
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KEYWORD
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Cesarean hysterectomy, Placenta accreta, Uterine transverse fundal incision
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