Uterine incision at the fundus, transitory devascularisation, and myometrial resection for uterine preservation in anterior accretism: a case report

Detalhes bibliográficos
Autor(a) principal: Rayra Amana Macedo Maciel
Data de Publicação: 2021
Outros Autores: Caio Ribeiro Vieira Leal, Bárbara Flecha D'Abreu, Mário Dias Corrêa Júnior, Admário Silva Santos Filho
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UFMG
Texto Completo: https://doi.org/10.33590/emjreprohealth/21-00007
http://hdl.handle.net/1843/54394
https://orcid.org/0000-0002-2535-3473
https://orcid.org/0000-0002-5859-0635
https://orcid.org/0000-0001-5223-8051
https://orcid.org/0000-0003-4198-0546
https://orcid.org/0000-0003-1631-5464
Resumo: Placenta accreta spectrum is a serious obstetric condition related to abnormal adherence of placental tissue to the myometrium and high maternal and fetal morbidity. In order to achieve the best outcome, the management of this condition must be carried out by an experienced multidisciplinary team and the individual characteristics of the patient must be taken into consideration, such as comorbidities and desire for reproductive preservation. This case report presents the conservative surgical management of placenta accreta spectrum in a 23-year-old patient who underwent an elective caesarean section with uterine preservation because of anterior placenta increta. The authors performed a transverse uterine incision at the fundus with transitory uterine devascularisation of the lower uterine segment with partial myometrial removal. This technique was successful for controlling the haemorrhage and preserving the uterus, with no complications.
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spelling 2023-06-02T19:36:33Z2023-06-02T19:36:33Z2021-08-10715459https://doi.org/10.33590/emjreprohealth/21-000072059-450Xhttp://hdl.handle.net/1843/54394https://orcid.org/0000-0002-2535-3473https://orcid.org/0000-0002-5859-0635https://orcid.org/0000-0001-5223-8051https://orcid.org/0000-0003-4198-0546https://orcid.org/0000-0003-1631-5464Placenta accreta spectrum is a serious obstetric condition related to abnormal adherence of placental tissue to the myometrium and high maternal and fetal morbidity. In order to achieve the best outcome, the management of this condition must be carried out by an experienced multidisciplinary team and the individual characteristics of the patient must be taken into consideration, such as comorbidities and desire for reproductive preservation. This case report presents the conservative surgical management of placenta accreta spectrum in a 23-year-old patient who underwent an elective caesarean section with uterine preservation because of anterior placenta increta. The authors performed a transverse uterine incision at the fundus with transitory uterine devascularisation of the lower uterine segment with partial myometrial removal. This technique was successful for controlling the haemorrhage and preserving the uterus, with no complications.O espectro da placenta acreta é uma condição obstétrica grave relacionada à aderência anormal do tecido placentário ao miométrio e alta morbidade materna e fetal. Para obter o melhor resultado, o manejo dessa condição deve ser feito por uma equipe multidisciplinar experiente e devem ser consideradas as características individuais do paciente, como comorbidades e desejo de preservação reprodutiva. Este relato de caso apresenta o manejo cirúrgico conservador do espectro de placenta acreta em uma paciente de 23 anos submetida a uma cesariana eletiva com preservação uterina devido a placenta anterior incretada. Os autores realizaram uma incisão uterina transversal no fundo com desvascularização uterina transitória do segmento uterino inferior com remoção parcial do miométrio. Esta técnica obteve sucesso no controle da hemorragia e na preservação do útero, sem complicações.engUniversidade Federal de Minas GeraisUFMGBrasilHCL - HOSPITAL DAS CLINICASMED - DEPARTAMENTO DE GINECOLOGIA OBSTETRÍCIAReproductive HealthCesáreaHemorragia pós-partoPlacenta acretaCaesarean sectionPlacenta accreta spectrumPostpartum haemorrhageUterine incision at the fundus, transitory devascularisation, and myometrial resection for uterine preservation in anterior accretism: a case reportIncisão uterina no fundo, desvascularização transitória e ressecção miometrial para preservação uterina em acretismo anterior: relato de casoinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://www.emjreviews.com/reproductive-health/article/uterine-incision-at-the-fundus-transitory-devascularisation-and-myometrial-resection-for-uterine-preservation-in-anterior-accretism-a-case-report-j150121/Rayra Amana Macedo MacielCaio Ribeiro Vieira LealBárbara Flecha D'AbreuMário Dias Corrêa JúniorAdmário Silva Santos Filhoapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/54394/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALUterine incision at the fundus, transitory devascularisation, and myometrial resection for uterine preservation in anterior accretism a case report.pdfUterine incision at the fundus, transitory devascularisation, and myometrial resection for uterine preservation in anterior accretism a case report.pdfapplication/pdf3274823https://repositorio.ufmg.br/bitstream/1843/54394/2/Uterine%20incision%20at%20the%20fundus%2c%20transitory%20devascularisation%2c%20and%20myometrial%20resection%20for%20uterine%20preservation%20in%20anterior%20accretism%20a%20case%20report.pdff7a1842fbd937020d4570fee2e703436MD521843/543942023-06-02 16:36:33.287oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-06-02T19:36:33Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
dc.title.pt_BR.fl_str_mv Uterine incision at the fundus, transitory devascularisation, and myometrial resection for uterine preservation in anterior accretism: a case report
dc.title.alternative.pt_BR.fl_str_mv Incisão uterina no fundo, desvascularização transitória e ressecção miometrial para preservação uterina em acretismo anterior: relato de caso
title Uterine incision at the fundus, transitory devascularisation, and myometrial resection for uterine preservation in anterior accretism: a case report
spellingShingle Uterine incision at the fundus, transitory devascularisation, and myometrial resection for uterine preservation in anterior accretism: a case report
Rayra Amana Macedo Maciel
Caesarean section
Placenta accreta spectrum
Postpartum haemorrhage
Cesárea
Hemorragia pós-parto
Placenta acreta
title_short Uterine incision at the fundus, transitory devascularisation, and myometrial resection for uterine preservation in anterior accretism: a case report
title_full Uterine incision at the fundus, transitory devascularisation, and myometrial resection for uterine preservation in anterior accretism: a case report
title_fullStr Uterine incision at the fundus, transitory devascularisation, and myometrial resection for uterine preservation in anterior accretism: a case report
title_full_unstemmed Uterine incision at the fundus, transitory devascularisation, and myometrial resection for uterine preservation in anterior accretism: a case report
title_sort Uterine incision at the fundus, transitory devascularisation, and myometrial resection for uterine preservation in anterior accretism: a case report
author Rayra Amana Macedo Maciel
author_facet Rayra Amana Macedo Maciel
Caio Ribeiro Vieira Leal
Bárbara Flecha D'Abreu
Mário Dias Corrêa Júnior
Admário Silva Santos Filho
author_role author
author2 Caio Ribeiro Vieira Leal
Bárbara Flecha D'Abreu
Mário Dias Corrêa Júnior
Admário Silva Santos Filho
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Rayra Amana Macedo Maciel
Caio Ribeiro Vieira Leal
Bárbara Flecha D'Abreu
Mário Dias Corrêa Júnior
Admário Silva Santos Filho
dc.subject.por.fl_str_mv Caesarean section
Placenta accreta spectrum
Postpartum haemorrhage
topic Caesarean section
Placenta accreta spectrum
Postpartum haemorrhage
Cesárea
Hemorragia pós-parto
Placenta acreta
dc.subject.other.pt_BR.fl_str_mv Cesárea
Hemorragia pós-parto
Placenta acreta
description Placenta accreta spectrum is a serious obstetric condition related to abnormal adherence of placental tissue to the myometrium and high maternal and fetal morbidity. In order to achieve the best outcome, the management of this condition must be carried out by an experienced multidisciplinary team and the individual characteristics of the patient must be taken into consideration, such as comorbidities and desire for reproductive preservation. This case report presents the conservative surgical management of placenta accreta spectrum in a 23-year-old patient who underwent an elective caesarean section with uterine preservation because of anterior placenta increta. The authors performed a transverse uterine incision at the fundus with transitory uterine devascularisation of the lower uterine segment with partial myometrial removal. This technique was successful for controlling the haemorrhage and preserving the uterus, with no complications.
publishDate 2021
dc.date.issued.fl_str_mv 2021-08-10
dc.date.accessioned.fl_str_mv 2023-06-02T19:36:33Z
dc.date.available.fl_str_mv 2023-06-02T19:36:33Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/1843/54394
dc.identifier.doi.pt_BR.fl_str_mv https://doi.org/10.33590/emjreprohealth/21-00007
dc.identifier.issn.pt_BR.fl_str_mv 2059-450X
dc.identifier.orcid.pt_BR.fl_str_mv https://orcid.org/0000-0002-2535-3473
https://orcid.org/0000-0002-5859-0635
https://orcid.org/0000-0001-5223-8051
https://orcid.org/0000-0003-4198-0546
https://orcid.org/0000-0003-1631-5464
url https://doi.org/10.33590/emjreprohealth/21-00007
http://hdl.handle.net/1843/54394
https://orcid.org/0000-0002-2535-3473
https://orcid.org/0000-0002-5859-0635
https://orcid.org/0000-0001-5223-8051
https://orcid.org/0000-0003-4198-0546
https://orcid.org/0000-0003-1631-5464
identifier_str_mv 2059-450X
dc.language.iso.fl_str_mv eng
language eng
dc.relation.ispartof.pt_BR.fl_str_mv Reproductive Health
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
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dc.publisher.none.fl_str_mv Universidade Federal de Minas Gerais
dc.publisher.initials.fl_str_mv UFMG
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv HCL - HOSPITAL DAS CLINICAS
MED - DEPARTAMENTO DE GINECOLOGIA OBSTETRÍCIA
publisher.none.fl_str_mv Universidade Federal de Minas Gerais
dc.source.none.fl_str_mv reponame:Repositório Institucional da UFMG
instname:Universidade Federal de Minas Gerais (UFMG)
instacron:UFMG
instname_str Universidade Federal de Minas Gerais (UFMG)
instacron_str UFMG
institution UFMG
reponame_str Repositório Institucional da UFMG
collection Repositório Institucional da UFMG
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