• Innovation of delivery of pregnant women with abnormally invasive placenta: placenta percreta (Case of practice)
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Innovation of delivery of pregnant women with abnormally invasive placenta: placenta percreta (Case of practice)

HEALTH OF WOMAN. 2018.5(132):19–24; doi 10.15574/HW.2018.132.19

Golyanovskiy O. V. , Mekhedko V. V. , Savonik A. O. , Goncharenko D. O. , Kucher V. M. , Vereshchagin S. V. , Gerasimov S. V.
Shupyk National Medical Academy of Postgraduate Education, Kiev
Kyiv Oblast Center for Maternal and Child Health
Kiev Regional Hospital

The article presents a case from practice with prenatal diagnostics of abnormally invasive placenta (Рl. Percreta) with invasion into the back wall of the bladder on the background of full placenta previa and previous caesarean section. Stressed the relevance of modern diagnostic pathologists placentation using ultrasound, Doppler and MRI to determine the depth of invasion of the placental tissue into the myometrium is emphasized. An innovative algorithm for delivery of a pregnant woman with this severe pathology using the endovascular technique of temporary balloon occlusion of the abdominal aorta, performing a cesarean section with a subsequent hysterectomy without appendages, ligating of the internal iliac arteries (IIAL), and argon-plasma tissue coagulation is proposed. The proposed method significantly reduces the amount of blood loss, the likelihood of developing massive bleeding, coagulopathic disorders and possible damage to adjacent organs.

Key words: abnormally invasive placenta, placenta increta/rercreta, placenta previa, massive obstetric hemorrhage, balloon occlusion of the aorta, argon-plasma tissue coagulation.

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