Temporary cross-clamping of the infrarenal abdominal aorta during cesarean hysterectomy to control operative blood loss in placenta previa increta/percreta
Objective To evaluate the efficacy and safety of temporary cross-clamping of the infrarenal abdominal aorta for controlling operative blood loss during cesarean hysterectomy in severe invasive placentation. Case Report A 35-year-old woman with a significant risk factor of four previous cesarean...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2010
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/12691/ http://irep.iium.edu.my/12691/ http://irep.iium.edu.my/12691/ http://irep.iium.edu.my/12691/1/TEMPORARY_CROSS-CLAMPING-SD.pdf |
| Summary: | Objective
To evaluate the efficacy and safety of temporary cross-clamping of the infrarenal abdominal aorta for controlling operative blood loss during cesarean hysterectomy in severe invasive placentation.
Case Report
A 35-year-old woman with a significant risk factor of four previous cesarean sections and placenta previa was referred to Taichung Veterans General Hospital with suspected abnormal placentation at 37 weeks of gestation. Obstetric ultrasonography and magnetic resonance imaging showed a bulky inhomogeneous placenta with extensive uterine serosa-bladder interface hypervascularity and suspicious focal bladder invasion. Cesarean hysterectomy was performed with the use of temporary cross-clamping of the infrarenal abdominal aorta. The duration of aortic cross-clamping was 1 hour, and the estimated blood loss was 2,000 mL. The patient was discharged home on postoperative day 11 with no postoperative sequelae.
Conclusion
With this limited experience, we are encouraged by the apparent reduction in operative blood loss after the use of temporary cross-clamping of the infrarenal abdominal aorta during cesarean hysterectomy. Further investigation is needed to determine the efficacy and safety of this procedure.
Key Words: aortic cross-clamping; blood loss; cesarean hysterectomy; placenta percreta
Correspondence to: Dr Min-Min Chou, Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, 160, Section 3, Taichungkang Road, Taichung, Taiwan
Copyright © 2010 Taiwan Association of Obstetric & Gynecology. Published by Elsevier B.V. All rights reserved |
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