A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta

Ceylan, Yasin; karadağ, cihan; Caliskan, Eray; Akar, Bertan

A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta

Eray Çalışkan, (Okan Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, İstanbul, Türkiye)

Bertan Akar, (İstinye Üniversitesi Tıp Fakültesi, Özel Kocaeli Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, Kocaeli, Türkiye)

Yasin Ceylan, (Kocaeli Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, Kocaeli, Türkiye)

Cihan Karadağ (Okan Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, İstanbul, Türkiye)

Turkish Journal of Obstetrics and Gynecology

6 1

Yıl: 2021 Cilt: 18 Sayı: 2 Sayfa Aralığı: 79 - 84 Metin Dili: İngilizce İndeks Tarihi: 15-01-2022

A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta

Öz:

Objective: Placenta previa (PP) and placenta accreta spectrum (PAS) disorders are major causes of postpartum hemorrhage (PPH). There is a variety of surgical management options with inexplicit reported success rates. Uterine sandwich is a combination of uterine compression sutures and intrauterine balloon placement to achieve hemostasis. The aim of this study was to present our experience of seven women managed with a novel “lower uterine sandwich” technique to control post-cesarean hemorrhage due to PP accreta. Materials and Methods: Seven pregnant women diagnosed as having PP totalis accreta underwent a post-cesarean procedure combining bilateral ligation of the uterine artery, utero-ovarian artery, and internal iliac artery, Pereira compression sutures implemented on the uterine isthmus, Foley catheter placement into the lower uterine segment, and transvaginal cervical cerclage application, namely “Caliskan’s uterine sandwich technique”. Results: All women included in this study had placental invasion abnormalities of varying degrees. Postoperative diffusion magnetic resonance imaging assessment revealed a completely normal and preserved uterine blood supply. All women menstruated regularly in their postoperative follow-up period and two women conceived again and delivered uneventfully. None of the patients experienced morbid complications nor required hysterectomy. Conclusion: This novel procedure appears to be a plausible fertility and organ-preserving option in cases of intractable PPH, particularly in lower uterine segment bleeding. This uterine sandwich technique may allow physicians to manage massive hemorrhage due to PAS conservatively by preserving the uterus and its functions without major complications.

Anahtar Kelime:

Plasenta previa accreta nedeniyle sezaryen sonrası kanama yönetiminde yeni alt uterin segment sandviç tekniği (Çalışkan tekniği)

Öz:

Amaç: Plasenta previa (PP) ve plasenta akreta spektrum (PAS) bozuklukları postpartum kanamanın (PPK) başlıca nedenleridir. Açıkça bildirilmemiş başarı oranları ile çeşitli cerrahi tedavi seçenekleri vardır. Uterin sandviç, hemostazı sağlamak için uterin kompresyon sütürleri ve uterus içi balon yerleştirilmesinin bir kombinasyonudur. Bu çalışmanın amacı, PP akretaya bağlı sezaryen sonrası kanamayı kontrol etmek için yeni bir “alt uterin sandviç” tekniği ile tedavi edilen yedi kadına ilişkin deneyimimizi sunmaktır. Gereç ve Yöntemler: PP totalis akreta tanısı konulan ve uterin arter, utero-ovaryan arter ve internal iliak arterin bilateral ligasyonu ile sezaryen sonrası işlem uygulanan yedi gebe kadın, uterin istmusa Pereira kompresyon sütürleri, Foley kateterinin alt uterin segmente yerleştirilmesi ve transvajinal servikal serklaj uygulaması, “Çalışkan’ın Uterin Sandviç Tekniği”, yapıldı. Bulgular: Bu çalışmaya dahil edilen tüm kadınlarda farklı derecelerde plasental invazyon anormallikleri vardı. Postoperatif difüzyon manyetik rezonans incelemesi, tamamen normal ve korunmuş uterus kan akımını ortaya çıkardı. Tüm kadınlar postoperatif takiplerinde düzenli olarak adet gördüler ve 2 kadın tekrar gebe kaldı ve sorunsuz doğum yaptı. Hastaların hiçbiri morbid komplikasyon yaşamadı ve histerektomi gerektirmedi. Sonuç: Bu yeni prosedür, inatçı PPK olgularında, özellikle alt uterin segment kanamalarında makul bir doğurganlık ve organ koruma seçeneği gibi görünmektedir. Bu uterin sandviç tekniği, kliniğin uterusu ve fonksiyonlarını büyük bir komplikasyon olmaksızın koruyarak PAS’ye bağlı masif kanamaları konservatif olarak yönetmesine izin verebilir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Caliskan E, Akar B, Ceylan Y, karadağ c (2021). A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta. , 79 - 84.
Chicago	Caliskan Eray,Akar Bertan,Ceylan Yasin,karadağ cihan A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta. (2021): 79 - 84.
MLA	Caliskan Eray,Akar Bertan,Ceylan Yasin,karadağ cihan A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta. , 2021, ss.79 - 84.
AMA	Caliskan E,Akar B,Ceylan Y,karadağ c A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta. . 2021; 79 - 84.
Vancouver	Caliskan E,Akar B,Ceylan Y,karadağ c A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta. . 2021; 79 - 84.
IEEE	Caliskan E,Akar B,Ceylan Y,karadağ c "A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta." , ss.79 - 84, 2021.
ISNAD	Caliskan, Eray vd. "A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta". (2021), 79-84.

APA	Caliskan E, Akar B, Ceylan Y, karadağ c (2021). A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta. Turkish Journal of Obstetrics and Gynecology, 18(2), 79 - 84.
Chicago	Caliskan Eray,Akar Bertan,Ceylan Yasin,karadağ cihan A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta. Turkish Journal of Obstetrics and Gynecology 18, no.2 (2021): 79 - 84.
MLA	Caliskan Eray,Akar Bertan,Ceylan Yasin,karadağ cihan A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta. Turkish Journal of Obstetrics and Gynecology, vol.18, no.2, 2021, ss.79 - 84.
AMA	Caliskan E,Akar B,Ceylan Y,karadağ c A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta. Turkish Journal of Obstetrics and Gynecology. 2021; 18(2): 79 - 84.
Vancouver	Caliskan E,Akar B,Ceylan Y,karadağ c A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta. Turkish Journal of Obstetrics and Gynecology. 2021; 18(2): 79 - 84.
IEEE	Caliskan E,Akar B,Ceylan Y,karadağ c "A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta." Turkish Journal of Obstetrics and Gynecology, 18, ss.79 - 84, 2021.
ISNAD	Caliskan, Eray vd. "A novel low uterine segment sandwich technique (Caliskan’s technique) for the management of postcesarean hemorrhage due to placenta previa accreta". Turkish Journal of Obstetrics and Gynecology 18/2 (2021), 79-84.