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Usefulness of transverse fundal incision method of cesarean section for women with placentas widely covering the entire anterior uterine wall

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Title: Usefulness of transverse fundal incision method of cesarean section for women with placentas widely covering the entire anterior uterine wall
Authors: Nishida, Ryutaro Browse this author
Yamada, Takahiro Browse this author →KAKEN DB
Akaishi, Rina Browse this author
Kojima, Takashi Browse this author
Ishikawa, Satoshi Browse this author
Takeda, Masamitsu Browse this author
Morikawa, Mamoru Browse this author →KAKEN DB
Yamada, Takashi Browse this author →KAKEN DB
Minakami, Hisanori Browse this author →KAKEN DB
Keywords: cesarean hysterectomy
placenta accrete
placenta previa
postpartum hemorrhage
Issue Date: Jan-2013
Publisher: Blackwell Publishing
Journal Title: Journal of Obstetrics and Gynaecology Research
Volume: 39
Issue: 1
Start Page: 91
End Page: 95
Publisher DOI: 10.1111/j.1447-0756.2012.01921.x
PMID: 22690852
Abstract: Aims: To assess the usefulness of a new method for cesarean section (CS) that is comprised of a transverse incision into the uterine fundus, developed for women with placentas covering the entire anterior uterine wall, and introduced in September 2006. Methods: Review of medical records of 12 and 29 women who underwent CS by the new and conventional methods, respectively, for placenta previa, placenta accreta (accreta, increta, and percreta), or placenta widely covering the entire anterior uterine wall in which placenta accreta cannot be excluded between June 2003 and March 2011. Results: Placenta accreta (67% [8/12] vs. 10% [3/29], P = 0.0006) and cesarean hysterectomy (67% vs. 10%) were significantly more frequent in the group with the new compared with the conventional method. There were no significant differences between groups with the new and conventional methods in amount of blood loss (1732 ± 1067 vs. 1847 ± 1279 g, respectively), prevalence of blood loss > 3000 g (8.3% vs. 17%, respectively) or blood transfusion (92% vs. 72%, respectively), time required for cesarean hysterectomy (210 ± 58 vs. 195 ± 41 min), or neonatal conditions at birth. The amount of blood loss for cesarean hysterectomy was significantly less for the new than conventional method (1959 ± 1025 g vs. 4450 ± 1145 g, P = 0.041). Conclusions: The new method was superior to the conventional method with respect to reduction of blood loss during cesarean hysterectomy. However, careful observations are mandatory in women with preserved uterus with respect to a possible increased risk of uterine rupture in future pregnancies.
Rights: The definitive version is available at Wiley Online Library,
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 山田 崇弘

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