title: Caesarean hysterectomy for placenta praevia/accreta using an approach via the pouch of Douglas.
abstract: Placenta praevia/accreta is associated with significant maternal morbidity and mortality and is a common cause of obstetric hysterectomy. This paper describes posterior retrograde abdominal hysterectomy, a new surgical technique for caesarean hysterectomy, in 11 women with placenta percreta, increta or accreta There were no intraoperative or postoperative maternal complications, and only one fetus required admission to the neonatal unit, for prematurity. Our technique in placenta praevia/accreta allows easy identification of the vagina and early uterine devascularisation, as well as safe resection of the involved urinary bladder in women with placenta percreta showing bladder penetration. Analytical studies are needed to confirm our findings.
  
  
  CONCLUSIONS
  Posterior retrograde abdominal hysterectomy in women with placenta praevia/accreta may enable safer surgery.
authors.affiliation: Department of Obstetrics and Gynaecology, Clinical Hospital, Universidad de Chile, Santiago, Chile.|Department of Obstetrics and Gynaecology, Clínica las Condes, Santiago, Chile.
authors.forename: A E
authors.initials: AE
authors.lastname: Selman
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010921:Placenta Accreta / Q000601:surgery*; D010923:Placenta Previa / Q000601:surgery*; D011247:Pregnancy; D016896:Treatment Outcome
keywords: Caesarean hysterectomy; cytoreductive surgery; ovarian cancer; placenta accreta; placenta previa