When is the ideal time to remove cerclage in cases requiring cesarean hysterectomy for placenta accreta spectrum?
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Date
2019-04
Journal Title
Journal ISSN
Volume Title
Publisher
Medip Academy
Abstract
Placenta accreta spectrum (PAS) presents one of the highest risks to pregnancy and often requires a cesarean hysterectomy for management, but the challenges associated with this surgery often cause severe obstetric haemorrhaging and high rates of maternal morbidity. Shirodkar cerclage is usually performed in cases with cervical insufficiency, a short cervix with previous preterm birth, etc., to decrease the preterm birth rate. It is recommended that Shirodkar cerclage is removed when the patient approaches term, but the ideal timing of removal for patient for whom cesarean hysterectomy is planned is not clear. Here, authors present a case of PAS in whom Shirodkar cerclage that was difficult to remove at the timing of cesarean hysterectomy. After cesarean hysterectomy, the patient had a vaginal abscess and required antibiotic therapy for approximately two weeks. In the light of our case, authors discuss the timing of removal of cerclage in the cases of PAS.
Description
Keywords
Cerclage, Placenta accreta spectrum, Placenta previa, Remove
Citation
Ito Futa, Matsuzaki Shinya, Endo Masayuki, Kimura Tadashi. When is the ideal time to remove cerclage in cases requiring cesarean hysterectomy for placenta accreta spectrum?. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2019 Apr; 8(4): 1668-1671