Journal of International Obstetrics and Gynecology ›› 2020, Vol. 47 ›› Issue (5): 569-574.

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Placenta Accreta related Hemostasis in Cesarean Section

TANG Xiao-tong, GE Zhi-ping   

  1. Department of Obstetrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
  • Received:2020-03-05 Revised:2020-03-19 Published:2020-10-15 Online:2020-10-27
  • Contact: GE Zhi-ping, E-mail: gzp88142@163.com E-mail:gzp88142@163.com

Abstract: Placental implantation not only leads to increased bleeding during cesarean section and postpartum, but also is one of the main causes endangering the life of pregnant women, so it is important to choose the appropriate hemostatic method. The current methods of hemostasis are mainly divided into the following categories: drug hemostasis, suture hemostasis, uterine packaging and vascular occlusion. Among them, drug hemostasis is the preferred method to reduce intraoperative and postpartum bleeding. If drugs cannot improve intraoperative bleeding, suture hemostasis, uterine packaging and vascular occlusion should be adopted. Drugs hemostasis, suture hemostasis, and uterine packaging are commonly used in combination with placenta accrete in cases of intraoperative hemorrhage. If the above methods are still unable to reduce bleeding, vascular occlusion should be promptly taken. Hysterectomy is usually used for refractory intraoperative and postpartum bleeding, but can result in permanent loss of fertility. This paper summarized the indications of different hemostatic methods in placenta accrete, and concluded that mastering the adaptive signs of different hemostatic methods and using them in combination are the abilities that obstetricians need to own in the future.

Key words: Placenta accreta;, Cesarean section;, Postpartum hemorrhage;, Hemostatics;, Hemostasis, surgical;, Suture techniques;, Vascular surgical procedures;, Hysterectomy