Clinical experience of circular resection in lower uterine segment and anastomosis of uterine ends for pernicious placenta previa combined with placenta accreta / 中华围产医学杂志

ABSTRACT

Objective To investigate the efficacy of anastomosis after circular resection of lower uterine segment of uterine ends in the treatment of pernicious placenta previa combined with placenta accreta.Methods Clinical data of three patients who were diagnosed with pernicious placenta previa combined with placenta accreta and treated with circular resection of lower uterine segment and anastomosis in Third Affiliated Hospital of Guangzhou Medical University from January to July 2016 were retrospectively analyzed.Efficacy of the treatment was evaluated by analyzing blood loss,vital signs and blood transfusion during operation,postoperative recovery and other parameters.Results Vital signs of the three patients were stable during operations.The volume of blood loss and blood transfusion during operation and operation time of the three patients were respectively 2 000 ml,400 ml and 110 min,1 520 ml,200 ml and 96 min,and 1 500 ml,200 ml and 90 min.None of them had postoperative infection and all were discharged within seven days after operation.The three patients all recovered well.Lochia discharge continued for 33,38 and 28 days,respectively.The menses were resumed respectively on the 289th,179th and 163rd day following operation without dysmenorrhea and all women had normal volume of menstruation.The cervical lengths of the three patients were 4.2,3.5 and 3.2 cm 90 days after operation,respectively.Results of imaging examination showed that uterine cavity were in normal shape and distinct endometrium were observed in all patients 90 days after operation.Conclusions Circular resection of lower uterine segment and anastomosis of lower ends of the uterine,which can effectively contol the intraoperative bleeding and retain the uteru,is highly effective for pernicious placenta previa combined with placenta accreta.