Surgical Technique To Control Postpartum Hemorrhage

Placenta accreta is an obstetrical complication where the placenta becomes firmly adherent to the uterine wall. Placenta accreta can lead to considerable maternal morbidity and mortality due to hemorrhage, infection, or other surgical complications such as those resulting from hysterectomy. Retained placenta accreta is usually a rare condition, but its prevalence is increasing due to the rise in the rate of deliveries by Cesarean section. Placenta accreta is a potentially life-threatening obstetric condition that requires a multidisciplinary approach to management. The incidence of placenta accreta has increased and seems to parallel the increasing cesarean delivery rate. Women at greatest risk of placenta accreta are those who have myometrial damage caused by a previous cesarean delivery with either an anterior or posterior placenta previa overlying the uterine scar. Diagnosis of placenta accreta before delivery allows multidisciplinary planning in an attempt to minimize potential maternal or neonatal morbidity and mortality.

Inclusion Criteria: Estimated gestational age between 34 -40 weeks . Presence of total or focal parts of placenta accreta "morbidly adherent placenta" . Cases with mild vaginal bleeding or not having any vaginal bleeding Exclusion Criteria: Severe attack of bleeding require an immediate intervention. Associated with placental abruption Patients with known bleeding disorders or on anticoagulant therapy. Preoperative decision to do peripartum hysterectomy.