title: Is the cold loop hysteroscopic technique a myometrial sparing treatment for placenta accreta residuals in a puerperal uterus?
abstract: Placenta accreta is a life-threatening obstetric pathology characterized by an abnormal invasion of chorionic villi into the uterine wall. The management represents a challenge for the gynecologist, especially in patients desiring to preserve their fertility. Several methods have been proposed to avoid hysterectomy. A case of a hysteroscopic conservative management with the cold loop technique in a puerpera with a large mass of placenta accreta residuals is described. The chorionic tissue was safely detached and it was subsequently removed by an electric cutting loop. Even in the absence of a clear cleavage plane, the thermal damage of surrounding healthy myometrium and dreadful complications as uterine perforation due to the electric cutting loop were avoided. The cold-loop hysteroscopic resection seems to be a safe and effective choice for the treatment of retained placenta accreta in patients desiring to preserve fertility. Moreover, it can also be proposed to patients who need to be treated immediately after delivery.
authors.affiliation: a "Arbor Vitae" Centre, Clinica Nuova Villa Claudia , Rome , Italy and.
authors.forename: Ivano
authors.initials: I
authors.lastname: Mazzon
authors.affiliation: b Department of Obstetrics and Gynecology , University of Perugia, S.M. della Misericordia Hospital , Perugia , Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Favilli
authors.affiliation: a "Arbor Vitae" Centre, Clinica Nuova Villa Claudia , Rome , Italy and.
authors.forename: Mario
authors.initials: M
authors.lastname: Grasso
authors.affiliation: a "Arbor Vitae" Centre, Clinica Nuova Villa Claudia , Rome , Italy and.
authors.forename: Stefano
authors.initials: S
authors.lastname: Horvath
authors.affiliation: b Department of Obstetrics and Gynecology , University of Perugia, S.M. della Misericordia Hospital , Perugia , Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Gerli
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D059351:Organ Sparing Treatments; D010921:Placenta Accreta / Q000601:surgery*; D011247:Pregnancy; D011644:Puerperal Disorders / Q000601:surgery*
keywords: Cold loop; hysteroscopy; operative hysteroscopy; placenta accrete; puerperal uterus