Placenta accreta.pptx
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This document discusses surgical approaches for placenta accreta, a severe pregnancy complication characterized by abnormal invasion of the placenta into the uterine wall that carries risks of life-threatening bleeding. It describes the types of placenta accreta (accreta, increta, percreta) and increased risks for women with placenta praevia and prior cesarean sections. The definitive treatment is cesarean hysterectomy, which can be performed conventionally, with modifications like the modified cesarean hysterectomy (MCH) technique, or via a posterior retrograde abdominal approach.
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This document discusses morbidly adherant placenta, also known as placenta accreta spectrum (PAS), which is becoming more common due to rising cesarean section rates. PAS occurs when the placenta invades deeply into the uterine wall and does not separate normally during delivery, potentially causing life-threatening hemorrhage. Early diagnosis through ultrasound screening and counseling of patients at high risk, such as those with prior uterine scarring, allows for improved maternal outcomes through preparedness and planned hysterectomy if needed. The key is anticipating PAS, making an accurate prenatal diagnosis, and being prepared to perform an emergency hysterectomy to control bleeding and save the mother's life if manual placental removal fails.
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This document discusses morbidly adherant placenta, also known as placenta accreta spectrum (PAS), which is becoming more common due to rising cesarean section rates. PAS occurs when the placenta invades deeply into the uterine wall and does not separate normally during delivery, potentially causing life-threatening hemorrhage. Early diagnosis through ultrasound screening and counseling of patients at high risk, such as those with prior uterine scarring, allows for improved maternal outcomes through preparedness and planned hysterectomy if needed. The key is anticipating PAS, making an accurate prenatal diagnosis, and being prepared to perform an emergency hysterectomy to control bleeding and save the mother's life if manual placental removal fails.
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Cesarean section is a surgical procedure to deliver babies through incisions in the abdominal wall and uterus. It is indicated when vaginal delivery poses risks to the mother or baby. The incidence of cesarean sections has risen in recent decades. There are two main types - lower segment and classical. Lower segment cesarean section through a transverse lower uterine incision is now the standard procedure. Complications can include hemorrhage, infection, and injury to other organs. Proper preoperative preparation and postoperative care and monitoring can help prevent complications.
vaginal birth after CS
This document provides guidance on counseling women considering a planned vaginal birth after cesarean (VBAC) versus elective repeat cesarean section. It outlines risk factors and success rates for VBAC, contraindications, intrapartum management recommendations, and discusses risks and benefits of both options to discuss with patients. Key factors that impact VBAC success rates and risks are previous vaginal delivery, induction, BMI over 30, gestational age, and birth weight. Continuous fetal monitoring and availability of emergency services are recommended for planned VBAC.
Caesareansection best
The document provides details about Caesarean delivery including:
- Caesarean section is the delivery of a fetus through an incision in the abdominal wall and uterus after 28 weeks of gestation.
- WHO recommends an ideal C-section rate of 15-20%.
- Reasons for the increasing rates of C-sections include improved safety, increased diagnosis of fetal distress, repeat C-sections, and client demand.
- The most common type is lower segment C-section which has a transverse incision in the lower uterine segment.
Vault Proplapse Repair
This document summarizes guidelines for managing vaginal vault prolapse after hysterectomy. It discusses prevention techniques during hysterectomy like McCall culdoplasty and ligament fixation. Assessment involves the POPQ system. Conservative options include pessaries but have unclear roles. Surgical options include sacrospinous fixation, sacrocolpopexy, and colpocleisis for frail patients. Sacrospinous fixation has shorter recovery but higher recurrence risks than sacrocolpopexy. Laparoscopic techniques require more skill but have shorter recovery. Slings and mesh reconstruction require further research.
Vbacs
This document discusses the history and risks/benefits of vaginal birth after cesarean (VBAC) versus elective repeat cesarean section. It notes that while VBAC was originally encouraged due to risks of multiple c-sections, safety concerns led to declining VBAC rates. VBAC carries risks of uterine rupture but reduces risks of respiratory issues compared to repeat c-section. Proper patient selection and access to emergency c-section are important to support a planned VBAC attempt. The risks and benefits should be discussed thoroughly to help each woman make an informed decision.
Lower segment cesarean section powe point presention
The document provides information about Caesarean section (C-section), including:
1. C-section is a surgical procedure to deliver babies through an incision in the mother's abdomen if vaginal delivery would put the baby or mother at risk.
2. The incidence of C-section is rising due to various factors like identification of at-risk fetuses/mothers, repeat C-sections, and decline in difficult vaginal deliveries.
3. Common indications for C-section include cephalo-pelvic disproportion, previous C-section, fetal distress, and breech presentation.
4. The procedure involves making an incision through skin, muscles and uterus to deliver the
Complications of peuperium
The document summarizes information about the postpartum period known as the puerperium. It defines the puerperium as the time period following childbirth from delivery of the placenta through the first few weeks as the body's anatomy and physiology revert back to the pre-pregnant state. Common anatomical changes and potential postpartum complications like postpartum hemorrhage are described. Postpartum hemorrhage is defined and its causes like uterine atony and genital tract lacerations are explained. Diagnosis and management of postpartum hemorrhage including conservative treatments and interventions like uterine packing or arterial ligation are outlined.
Cervical incompetence
Cervical incompetence, or premature cervical dilation, can complicate 0.1-2% of pregnancies and cause 15% of preterm births between 16-28 weeks. While the exact cause is often unknown, it may result from congenital cervical weakness, trauma, or DES exposure. Diagnosis is based on recurrent second trimester miscarriage without other identifiable causes. Treatment options include bed rest or a cervical cerclage procedure to stitch the cervix closed and prolong the pregnancy. Cerclage placement can be elective, urgent based on cervical shortening, or emergency if dilation has already begun. The McDonald and Shirodkar techniques are most common, with choice depending on cervical anatomy and prior trauma. Cer
USMLE GENERAL EMBRYOLOGY 016 Anomalies placenta and umbilical cord.pdf
Anomalies of the placenta and umbilical cord can have significant implications for the health and development of the fetus during pregnancy. These anomalies may affect blood flow, nutrient exchange, and overall fetal well- being.
Early detection and appropriate management of placental and umbilical cord anomalies are essential for optimizing outcomes for both the mother and the baby. Prenatal screening, ultrasound examinations, and close monitoring during pregnancy are crucial for identifying and addressing potential issues.
Hospital Based Surgical Procedures IN POST PARTUM HAEMORRHAGE : Dr Sharda Jai...
1) The document discusses various hospital-based surgical procedures for treating postpartum haemorrhage (PPH), including the B-Lynch suture, Cho suture, uterine artery ligation, embolization, hysterectomy, and stepwise devascularization.
2) It emphasizes the importance of having competent obstetricians trained in these procedures available, as well as proper infrastructure and prerequisites like a stable patient and experienced surgeon.
3) Uterine artery ligation is presented as the first step in systematic devascularization for controlling PPH, while hysterectomy is described as a last resort option to save the mother's life if other treatments are unsuccessful or unavailable.
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Placenta accreta.pptx
- 1. Surgical Aproach to Placenta Accreta Dr. Muhammad Atif Khan Assoc. Prof. Surgery Holy Family Hospital, Rwp
- 2. A severe complication of pregnancy Risk for massive and potentially lifethreatening intrapartum and postpartum haemorrhage. Placenta Accreta
- 3. Accreta 75% Increta 18% Percreta 7% Incidence A.C.O.G: American College of Obstetricians and Gynecologists 67% in patients with placenta praevia and multiple previous c/s.
- 4. Types
- 5. Pathogenesis
- 6. Management
- 7. The definitive treatment of placenta accreta is cesarean hysterectomy. 1. Conventional cesarean hysterectomy 2. Modified cesarean hysterectomy (MCH) 3. Posterior retrograde abdominal hysterectomy Cesarean hysterectomy
- 8. Mid-longitudinal incision of the lower abdomen An oblique or “J” shaped incision in the lower uterine segment is often applied. Delivery of the fetus. Application of elastic bandage tourniquet around the level of the cervical internal os. Modified cesarean hysterectomy (MCH)
- 9. (A) Cord clamping. (B) Cervical ligation by Foley's catheter. (C) Cessation of bleeding after cervical ligation.
- 10. Lithotomy position Fundal hysterotomy away from the placenta. Hysterotomy closure with a continuous suture (for aemostasis). Ligature of the anterior divisions of the internal iliac arteries. Posterior vaginal fornix is exposed by placement of a sponge stick into the vagina, which is opened transversely, 1–2 cm below the cervicovaginal junction. Caesarean hysterectomy via posterior retrograde approach. Posterior retrograde abdominal Hysterectomy
- 12. Easy identification of the vagina and early uterine devascularisation. Safe resection of the involved urinary bladder. Advantages
- 13. Publications Committee, Society for Maternal-Fetal Medicine, Belfort MA. Placenta accreta. Am J Obstet Gynecol 2010;203:430–9. Faranesh R, Romanov S, Shalev E, Salim R. Suggested approach for management of placenta percreta invading the urinary bladder. Obstet Gynecol 2007;110:512–15. Committee on Obstetric Practice. Committee opinion no. 529:placenta accreta. Obstet Gynecol 2012;120:207–11. Refrences