Document Detail


Cesarean hysterectomy requiring emergent thoracotomy: a case report of a complication of placenta percreta requiring a multidisciplinary effort.
MedLine Citation:
PMID:  22324270     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Currently a leading indication for cesarean hysterectomy among multiparous women, placenta accreta is associated with significant maternal morbidity and mortality.
CASE: A 34-year-old woman with a pregnancy complicated by placenta previa and previous cesarean deliveries was transferred to our institution following late diagnosis of placenta percreta. She underwent cesarean hysterectomy complicated by substantial hemorrhage. Massive blood product replacement precipitated severe hyperkaIemia and hypocalcemia with resultant asystole. Cardiac bypass with concomitant obligate anticoagulation was temporarily required while normalizing the patient's electrolytes. Numerous surgical and medical interventions were required to achieve hemostasis, and the patient survived to hospital discharge with moderate residual morbidity.
CONCLUSION: Optimal management of placenta accreta requires a multidisciplinary approach within a tertiary center possessing extensive resources necessary for managing the most severe complications.
Authors:
Shai Pri-Paz; Patricia C Devine; Russell S Miller; Pamela D Flood; Sherelle L Laifer-Narin; Jason D Wright
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  57     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:    2012 Jan-Feb
Date Detail:
Created Date:  2012-02-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  58-60     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY 10032, USA. smp9009@med.cornell.edu
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