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Use of a Fibrin Sealant Patch at Cesarean for Conservative Management of Morbidly Adherent Placenta

Background  Morbidly adherent placenta represents a surgical challenge and source of maternal morbidity and mortality. We report the use of a fibrin sealant patch to address hemorrhage associated with a morbidly adherent placenta during cesarean delivery. Case  A patient underwent repeat cesarean de...

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Detalles Bibliográficos
Autores principales: Greenberg, James A., Robinson, Julian N., Carabuena, Jean M., Farber, Michaela K., Carusi, Daniela A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical Publishers 2018
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6235679/
https://www.ncbi.nlm.nih.gov/pubmed/30443434
http://dx.doi.org/10.1055/s-0038-1675848
Descripción
Sumario:Background  Morbidly adherent placenta represents a surgical challenge and source of maternal morbidity and mortality. We report the use of a fibrin sealant patch to address hemorrhage associated with a morbidly adherent placenta during cesarean delivery. Case  A patient underwent repeat cesarean delivery with complete anterior placenta previa and anticipated morbidly adherent placenta. Bleeding persisted following delivery and removal of the placenta, despite uterine artery embolization. A fibrin sealant patch was applied as an adjuvant intervention to the placental bed and hemostasis was achieved without resorting to a hysterectomy. Conclusion  Postpartum hemorrhage is an ongoing leading source of maternal morbidity and mortality. A case is presented in which a fibrin sealant patch provided control of focal placental bed bleeding, allowing removal of a focal morbidly adherent placenta and avoidance of hysterectomy.