Shigeki Matsubara1, Hironori Takahashi2, Yosuke Baba2. 1. Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. matsushi@jichi.ac.jp. 2. Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
Abstract
BACKGROUND: At cesarean hysterectomy for abnormally invasive placenta, rupture of aberrant vessels around the uterus causes massive bleeding. PURPOSE: This study aimed at describing a technique to reduce bleeding from aberrant vessels at the posterior bladder wall in this surgery. METHODS: The bladder is filled with 200-300 mL of water during handling the posterior bladder wall. RESULTS: This technique facilitates understanding that some aberrant vessels do not have communications with the cervix-uterus. Some aberrant vessels have communication with the cervix-uterus and this technique makes cutting and ligation of these vessels easy. CONCLUSIONS: Filling the bladder may reduce bleeding from the posterior bladder wall at cesarean hysterectomy for abnormally invasive placenta.
BACKGROUND: At cesarean hysterectomy for abnormally invasive placenta, rupture of aberrant vessels around the uterus causes massive bleeding. PURPOSE: This study aimed at describing a technique to reduce bleeding from aberrant vessels at the posterior bladder wall in this surgery. METHODS: The bladder is filled with 200-300 mL of water during handling the posterior bladder wall. RESULTS: This technique facilitates understanding that some aberrant vessels do not have communications with the cervix-uterus. Some aberrant vessels have communication with the cervix-uterus and this technique makes cutting and ligation of these vessels easy. CONCLUSIONS: Filling the bladder may reduce bleeding from the posterior bladder wall at cesarean hysterectomy for abnormally invasive placenta.