EP02.05: Bilateral hypogastric artery ligation before hysterectomy with placenta in situ in cases of placenta precreta: can it reduce maternal morbidity?

Abstract

Evaluate the role of hypogastric artery ligation in cases placenta accrete before hysterectomy with placenta in situ to reduce the amount of blood loss and decrease the maternal morbidities. Retrospective descriptive interventional study of women (< span style = “line-height:20.7999992370605px” > 10 cases reported in the period from Jan 2013–Jan 2015). In our few cases, antepartum ultrasound diagnosed placenta percreta with suspicion of invasion to bladder using colour Doppler US and 3D power Doppler techniques, planned Peripartum hysterectomy preceded by bilateral hypogastric arteries ligation, intraoperative time; amount of blood transfused intraoperatively. Need for additional vaginal hemostatic, sutures ureteric injury or ligation, duration of ICU stay, incidence of DIC and need for additional surgical interference all are decreased dramatically. Prenatal diagnosed placenta percreta using ultrasound with bladder invasion and new surgical technique of bilateral hypogateric arteries ligation is considered an effective method before hysterectomy especially in cases of placenta percreta aiming to decrease all maternal morbidities of such cases.