title: Important surgical measures and techniques at cesarean hysterectomy for placenta previa accreta.
abstract: For cesarean hysterectomy with placenta previa accreta, "universally achievable" measures are required. We propose eight measures: (i) placement of intra-iliac arterial occlusion balloon catheters; (ii) placement of ureter stents; (iii) "holding the cervix" to identify the site to be transected; (iv) uterine fundal incision; (v) avoidance of uterotonics; (vi) "M cross double ligation" for ligating the ovarian ligament; (vii) "filling the bladder" to identify the bladder separation site and "opening the bladder" for placenta previa accreta with bladder invasion; and (viii) to continue to clamp the medial side of the parametrium or the cervix or employment of the "double edge pick-up" to ligate it. These eight measures are simple, easy, effective, and thus "universally achievable".
authors: Departments of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan. matsushi@jichi.ac.jp
authors: Shigeki
authors: S
authors: Matsubara
authors: Tomoyuki
authors: T
authors: Kuwata
authors: Rie
authors: R
authors: Usui
authors: Takashi
authors: T
authors: Watanabe
authors: Akio
authors: A
authors: Izumi
authors: Akihide
authors: A
authors: Ohkuchi
authors: Mitsuaki
authors: M
authors: Suzuki
authors: Manabu
authors: M
authors: Nakata
mesh_terms: D000328:Adult; D021721:Balloon Occlusion / Q000706:statistics & numerical data; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002404:Catheterization / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D007044:Hysterectomy / Q000379:methods* / Q000706:statistics & numerical data; D010921:Placenta Accreta / Q000453:epidemiology* / Q000601:surgery*; D010923:Placenta Previa / Q000453:epidemiology* / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D014592:Uterine Hemorrhage / Q000517:prevention & control; D055815:Young Adult