Organ-preserving technologies and their effectiveness in patients with placenta accret

Abstract

In recent years, in practical obstetrics, placental adherence into the myometrium, diagnosed after the birth of the fetus during caesarean section or in the 3rd period of labor, has become increasingly common. It causes massive bleeding, hysterectomy and maternal mortality. Purpose: To assess the outcome of childbirth with organ-preserving technology in cases of placenta accreta. Material and methods: 56 women in placenta accreta were observed and delivered for 2016-2018. 49 women delivered by Cesarean section and 7 women gave vaginal delivery. Two methods were used to preserve the uterus during placenta accreta: the first method -35 women who have laparotomy, a cesarean section with a section on the uterus above the scar and above the edge of the placenta, ligation of the uterine arteries, excision of the incremental area and metroplasty, imposition of compression sutures on the uterus. The second method -7 women after vaginal delivery left the whole or part of the placenta in the uterus - placenta in situ. The risk of placenta accreta was placenta previa, scar on the uterus, abortions in anamnesis, over 30 years of age third or more births. Results and discussion: From 35 pregnant women who underwent an organ-preserving procedure for caesarean section, 33 (94,3%) women managed to preserve the uterus, the remaining 2 (5,7%) women underwent hysterectomy Of 7 cases of placenta in situ, in 2 (28,6%) cases a hysterectomy was performed и. and uterus was preserved in 5 (71.4%) women. Conclusions: The effectiveness of improved organ-preserving technology to preserve the reproductive function of women with placenta accreta is high. In the group with the organ-preserving method with placenta, the volume of blood loss, the volume of transfusion of blood components is much lower than in the hysterectomy group.