Temporary cross-clamping of the infrarenal abdominal aorta during cesarean hysterectomy to control operative blood loss in placenta previa increta/percreta

Min-Min, Chou and You-Min, Ke and Huey-Chun, Wu and Ching-Pei, Tsai and Esther, Shih-Chu Ho and Ismail, Hamizah and Jaraquemada, Jose M. Palacios (2010) Temporary cross-clamping of the infrarenal abdominal aorta during cesarean hysterectomy to control operative blood loss in placenta previa increta/percreta. Taiwanese Journal of Obstetrics and Gynecology, 49 (1). pp. 72-76. ISSN 1028-4559

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Abstract

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

Item Type:	Article (Journal)
Additional Information:	5526/12691
Uncontrolled Keywords:	aortic cross-clamping; blood loss; cesarean hysterectomy; placenta percreta
Subjects:	R Medicine > RZ Other systems of medicine
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine
Depositing User:	Nurul Iftitah Noryazid (PT)
Date Deposited:	14 Mar 2012 11:41
Last Modified:	14 Mar 2012 11:42
URI:	http://irep.iium.edu.my/id/eprint/12691

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