Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study

Abstract Background Placenta accreta spectrum (PAS) cesarean hysterectomy is performed under conditions of shock and can result in serious complications. This study aimed to evaluate the usefulness of the “Holding-up uterus” surgical technique with a shock index (S.I.) < 1.5. Methods Twelve patie...
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Autor*in:	Jin Takahashi [verfasserIn] Makoto Orisaka [verfasserIn] Daisuke Inoue [verfasserIn] Hiroshi Kawamura [verfasserIn] Nozomu Takahashi [verfasserIn] Hideaki Tsuyoshi [verfasserIn] Akiko Shinagawa [verfasserIn] Tetsuji Kurokawa [verfasserIn] Yoshio Yoshida [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2024

Schlagwörter:	Placenta accreta spectrum Cesarean hysterectomy Shock index Holding-up uterus technique Preoperative intervention

Übergeordnetes Werk:	In: BMC Surgery - BMC, 2003, 24(2024), 1, Seite 8
Übergeordnetes Werk:	volume:24 ; year:2024 ; number:1 ; pages:8

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1186/s12893-024-02311-8

Katalog-ID:	DOAJ097670995

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520			\|a Abstract Background Placenta accreta spectrum (PAS) cesarean hysterectomy is performed under conditions of shock and can result in serious complications. This study aimed to evaluate the usefulness of the “Holding-up uterus” surgical technique with a shock index (S.I.) < 1.5. Methods Twelve patients who underwent PAS cesarean hysterectomy were included in the study. Results Group I had S.I. < 1.5, and group II had S.I. ≤ 1.5. Group I had more complications, but none were above Grade 3 or fatal. Preoperative scheduled uterine artery embolization did not result in serious complications, but three patients who had emergency common iliac artery balloon occlusion (CIABO) and a primary total hysterectomy with S.I. < 1.5 had postoperative Grade 2 thrombosis. Two patients underwent manual ablation of the placenta under CIABO to preserve the uterus, both with S.I. < 1.5. Conclusions The study found that the “Holding-up uterus” technique was safe, even in critical situations with S.I. < 1.5. CIABO had no intervention effect. The study also identified assisted reproductive technology pregnancies with a uterine cavity length of less than 5 cm before conception as a critical factor.
650		4	\|a Placenta accreta spectrum
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allfields	10.1186/s12893-024-02311-8 doi (DE-627)DOAJ097670995 (DE-599)DOAJ3a8c8dd36dc94c859d2739a16773ebdd DE-627 ger DE-627 rakwb eng RD1-811 Jin Takahashi verfasserin aut Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Placenta accreta spectrum (PAS) cesarean hysterectomy is performed under conditions of shock and can result in serious complications. This study aimed to evaluate the usefulness of the “Holding-up uterus” surgical technique with a shock index (S.I.) < 1.5. Methods Twelve patients who underwent PAS cesarean hysterectomy were included in the study. Results Group I had S.I. < 1.5, and group II had S.I. ≤ 1.5. Group I had more complications, but none were above Grade 3 or fatal. Preoperative scheduled uterine artery embolization did not result in serious complications, but three patients who had emergency common iliac artery balloon occlusion (CIABO) and a primary total hysterectomy with S.I. < 1.5 had postoperative Grade 2 thrombosis. Two patients underwent manual ablation of the placenta under CIABO to preserve the uterus, both with S.I. < 1.5. Conclusions The study found that the “Holding-up uterus” technique was safe, even in critical situations with S.I. < 1.5. CIABO had no intervention effect. The study also identified assisted reproductive technology pregnancies with a uterine cavity length of less than 5 cm before conception as a critical factor. Placenta accreta spectrum Cesarean hysterectomy Shock index Holding-up uterus technique Preoperative intervention Surgery Makoto Orisaka verfasserin aut Daisuke Inoue verfasserin aut Hiroshi Kawamura verfasserin aut Nozomu Takahashi verfasserin aut Hideaki Tsuyoshi verfasserin aut Akiko Shinagawa verfasserin aut Tetsuji Kurokawa verfasserin aut Yoshio Yoshida verfasserin aut In BMC Surgery BMC, 2003 24(2024), 1, Seite 8 (DE-627)331018837 (DE-600)2050442-1 14712482 nnns volume:24 year:2024 number:1 pages:8 https://doi.org/10.1186/s12893-024-02311-8 kostenfrei https://doaj.org/article/3a8c8dd36dc94c859d2739a16773ebdd kostenfrei https://doi.org/10.1186/s12893-024-02311-8 kostenfrei https://doaj.org/toc/1471-2482 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 24 2024 1 8
spelling	10.1186/s12893-024-02311-8 doi (DE-627)DOAJ097670995 (DE-599)DOAJ3a8c8dd36dc94c859d2739a16773ebdd DE-627 ger DE-627 rakwb eng RD1-811 Jin Takahashi verfasserin aut Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Placenta accreta spectrum (PAS) cesarean hysterectomy is performed under conditions of shock and can result in serious complications. This study aimed to evaluate the usefulness of the “Holding-up uterus” surgical technique with a shock index (S.I.) < 1.5. Methods Twelve patients who underwent PAS cesarean hysterectomy were included in the study. Results Group I had S.I. < 1.5, and group II had S.I. ≤ 1.5. Group I had more complications, but none were above Grade 3 or fatal. Preoperative scheduled uterine artery embolization did not result in serious complications, but three patients who had emergency common iliac artery balloon occlusion (CIABO) and a primary total hysterectomy with S.I. < 1.5 had postoperative Grade 2 thrombosis. Two patients underwent manual ablation of the placenta under CIABO to preserve the uterus, both with S.I. < 1.5. Conclusions The study found that the “Holding-up uterus” technique was safe, even in critical situations with S.I. < 1.5. CIABO had no intervention effect. The study also identified assisted reproductive technology pregnancies with a uterine cavity length of less than 5 cm before conception as a critical factor. Placenta accreta spectrum Cesarean hysterectomy Shock index Holding-up uterus technique Preoperative intervention Surgery Makoto Orisaka verfasserin aut Daisuke Inoue verfasserin aut Hiroshi Kawamura verfasserin aut Nozomu Takahashi verfasserin aut Hideaki Tsuyoshi verfasserin aut Akiko Shinagawa verfasserin aut Tetsuji Kurokawa verfasserin aut Yoshio Yoshida verfasserin aut In BMC Surgery BMC, 2003 24(2024), 1, Seite 8 (DE-627)331018837 (DE-600)2050442-1 14712482 nnns volume:24 year:2024 number:1 pages:8 https://doi.org/10.1186/s12893-024-02311-8 kostenfrei https://doaj.org/article/3a8c8dd36dc94c859d2739a16773ebdd kostenfrei https://doi.org/10.1186/s12893-024-02311-8 kostenfrei https://doaj.org/toc/1471-2482 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 24 2024 1 8
allfields_unstemmed	10.1186/s12893-024-02311-8 doi (DE-627)DOAJ097670995 (DE-599)DOAJ3a8c8dd36dc94c859d2739a16773ebdd DE-627 ger DE-627 rakwb eng RD1-811 Jin Takahashi verfasserin aut Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Placenta accreta spectrum (PAS) cesarean hysterectomy is performed under conditions of shock and can result in serious complications. This study aimed to evaluate the usefulness of the “Holding-up uterus” surgical technique with a shock index (S.I.) < 1.5. Methods Twelve patients who underwent PAS cesarean hysterectomy were included in the study. Results Group I had S.I. < 1.5, and group II had S.I. ≤ 1.5. Group I had more complications, but none were above Grade 3 or fatal. Preoperative scheduled uterine artery embolization did not result in serious complications, but three patients who had emergency common iliac artery balloon occlusion (CIABO) and a primary total hysterectomy with S.I. < 1.5 had postoperative Grade 2 thrombosis. Two patients underwent manual ablation of the placenta under CIABO to preserve the uterus, both with S.I. < 1.5. Conclusions The study found that the “Holding-up uterus” technique was safe, even in critical situations with S.I. < 1.5. CIABO had no intervention effect. The study also identified assisted reproductive technology pregnancies with a uterine cavity length of less than 5 cm before conception as a critical factor. Placenta accreta spectrum Cesarean hysterectomy Shock index Holding-up uterus technique Preoperative intervention Surgery Makoto Orisaka verfasserin aut Daisuke Inoue verfasserin aut Hiroshi Kawamura verfasserin aut Nozomu Takahashi verfasserin aut Hideaki Tsuyoshi verfasserin aut Akiko Shinagawa verfasserin aut Tetsuji Kurokawa verfasserin aut Yoshio Yoshida verfasserin aut In BMC Surgery BMC, 2003 24(2024), 1, Seite 8 (DE-627)331018837 (DE-600)2050442-1 14712482 nnns volume:24 year:2024 number:1 pages:8 https://doi.org/10.1186/s12893-024-02311-8 kostenfrei https://doaj.org/article/3a8c8dd36dc94c859d2739a16773ebdd kostenfrei https://doi.org/10.1186/s12893-024-02311-8 kostenfrei https://doaj.org/toc/1471-2482 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 24 2024 1 8
allfieldsGer	10.1186/s12893-024-02311-8 doi (DE-627)DOAJ097670995 (DE-599)DOAJ3a8c8dd36dc94c859d2739a16773ebdd DE-627 ger DE-627 rakwb eng RD1-811 Jin Takahashi verfasserin aut Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Placenta accreta spectrum (PAS) cesarean hysterectomy is performed under conditions of shock and can result in serious complications. This study aimed to evaluate the usefulness of the “Holding-up uterus” surgical technique with a shock index (S.I.) < 1.5. Methods Twelve patients who underwent PAS cesarean hysterectomy were included in the study. Results Group I had S.I. < 1.5, and group II had S.I. ≤ 1.5. Group I had more complications, but none were above Grade 3 or fatal. Preoperative scheduled uterine artery embolization did not result in serious complications, but three patients who had emergency common iliac artery balloon occlusion (CIABO) and a primary total hysterectomy with S.I. < 1.5 had postoperative Grade 2 thrombosis. Two patients underwent manual ablation of the placenta under CIABO to preserve the uterus, both with S.I. < 1.5. Conclusions The study found that the “Holding-up uterus” technique was safe, even in critical situations with S.I. < 1.5. CIABO had no intervention effect. The study also identified assisted reproductive technology pregnancies with a uterine cavity length of less than 5 cm before conception as a critical factor. Placenta accreta spectrum Cesarean hysterectomy Shock index Holding-up uterus technique Preoperative intervention Surgery Makoto Orisaka verfasserin aut Daisuke Inoue verfasserin aut Hiroshi Kawamura verfasserin aut Nozomu Takahashi verfasserin aut Hideaki Tsuyoshi verfasserin aut Akiko Shinagawa verfasserin aut Tetsuji Kurokawa verfasserin aut Yoshio Yoshida verfasserin aut In BMC Surgery BMC, 2003 24(2024), 1, Seite 8 (DE-627)331018837 (DE-600)2050442-1 14712482 nnns volume:24 year:2024 number:1 pages:8 https://doi.org/10.1186/s12893-024-02311-8 kostenfrei https://doaj.org/article/3a8c8dd36dc94c859d2739a16773ebdd kostenfrei https://doi.org/10.1186/s12893-024-02311-8 kostenfrei https://doaj.org/toc/1471-2482 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 24 2024 1 8
allfieldsSound	10.1186/s12893-024-02311-8 doi (DE-627)DOAJ097670995 (DE-599)DOAJ3a8c8dd36dc94c859d2739a16773ebdd DE-627 ger DE-627 rakwb eng RD1-811 Jin Takahashi verfasserin aut Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Placenta accreta spectrum (PAS) cesarean hysterectomy is performed under conditions of shock and can result in serious complications. This study aimed to evaluate the usefulness of the “Holding-up uterus” surgical technique with a shock index (S.I.) < 1.5. Methods Twelve patients who underwent PAS cesarean hysterectomy were included in the study. Results Group I had S.I. < 1.5, and group II had S.I. ≤ 1.5. Group I had more complications, but none were above Grade 3 or fatal. Preoperative scheduled uterine artery embolization did not result in serious complications, but three patients who had emergency common iliac artery balloon occlusion (CIABO) and a primary total hysterectomy with S.I. < 1.5 had postoperative Grade 2 thrombosis. Two patients underwent manual ablation of the placenta under CIABO to preserve the uterus, both with S.I. < 1.5. Conclusions The study found that the “Holding-up uterus” technique was safe, even in critical situations with S.I. < 1.5. CIABO had no intervention effect. The study also identified assisted reproductive technology pregnancies with a uterine cavity length of less than 5 cm before conception as a critical factor. Placenta accreta spectrum Cesarean hysterectomy Shock index Holding-up uterus technique Preoperative intervention Surgery Makoto Orisaka verfasserin aut Daisuke Inoue verfasserin aut Hiroshi Kawamura verfasserin aut Nozomu Takahashi verfasserin aut Hideaki Tsuyoshi verfasserin aut Akiko Shinagawa verfasserin aut Tetsuji Kurokawa verfasserin aut Yoshio Yoshida verfasserin aut In BMC Surgery BMC, 2003 24(2024), 1, Seite 8 (DE-627)331018837 (DE-600)2050442-1 14712482 nnns volume:24 year:2024 number:1 pages:8 https://doi.org/10.1186/s12893-024-02311-8 kostenfrei https://doaj.org/article/3a8c8dd36dc94c859d2739a16773ebdd kostenfrei https://doi.org/10.1186/s12893-024-02311-8 kostenfrei https://doaj.org/toc/1471-2482 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 24 2024 1 8
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This study aimed to evaluate the usefulness of the “Holding-up uterus” surgical technique with a shock index (S.I.) < 1.5. Methods Twelve patients who underwent PAS cesarean hysterectomy were included in the study. Results Group I had S.I. < 1.5, and group II had S.I. ≤ 1.5. Group I had more complications, but none were above Grade 3 or fatal. Preoperative scheduled uterine artery embolization did not result in serious complications, but three patients who had emergency common iliac artery balloon occlusion (CIABO) and a primary total hysterectomy with S.I. < 1.5 had postoperative Grade 2 thrombosis. Two patients underwent manual ablation of the placenta under CIABO to preserve the uterus, both with S.I. < 1.5. Conclusions The study found that the “Holding-up uterus” technique was safe, even in critical situations with S.I. < 1.5. CIABO had no intervention effect. 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callnumber-first	R - Medicine
author	Jin Takahashi
spellingShingle	Jin Takahashi misc RD1-811 misc Placenta accreta spectrum misc Cesarean hysterectomy misc Shock index misc Holding-up uterus technique misc Preoperative intervention misc Surgery Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study
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topic_title	RD1-811 Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study Placenta accreta spectrum Cesarean hysterectomy Shock index Holding-up uterus technique Preoperative intervention
topic	misc RD1-811 misc Placenta accreta spectrum misc Cesarean hysterectomy misc Shock index misc Holding-up uterus technique misc Preoperative intervention misc Surgery
topic_unstemmed	misc RD1-811 misc Placenta accreta spectrum misc Cesarean hysterectomy misc Shock index misc Holding-up uterus technique misc Preoperative intervention misc Surgery
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title	Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study
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title_full	Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study
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author_browse	Jin Takahashi Makoto Orisaka Daisuke Inoue Hiroshi Kawamura Nozomu Takahashi Hideaki Tsuyoshi Akiko Shinagawa Tetsuji Kurokawa Yoshio Yoshida
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title_sort	evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study
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title_auth	Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study
abstract	Abstract Background Placenta accreta spectrum (PAS) cesarean hysterectomy is performed under conditions of shock and can result in serious complications. This study aimed to evaluate the usefulness of the “Holding-up uterus” surgical technique with a shock index (S.I.) < 1.5. Methods Twelve patients who underwent PAS cesarean hysterectomy were included in the study. Results Group I had S.I. < 1.5, and group II had S.I. ≤ 1.5. Group I had more complications, but none were above Grade 3 or fatal. Preoperative scheduled uterine artery embolization did not result in serious complications, but three patients who had emergency common iliac artery balloon occlusion (CIABO) and a primary total hysterectomy with S.I. < 1.5 had postoperative Grade 2 thrombosis. Two patients underwent manual ablation of the placenta under CIABO to preserve the uterus, both with S.I. < 1.5. Conclusions The study found that the “Holding-up uterus” technique was safe, even in critical situations with S.I. < 1.5. CIABO had no intervention effect. The study also identified assisted reproductive technology pregnancies with a uterine cavity length of less than 5 cm before conception as a critical factor.
abstractGer	Abstract Background Placenta accreta spectrum (PAS) cesarean hysterectomy is performed under conditions of shock and can result in serious complications. This study aimed to evaluate the usefulness of the “Holding-up uterus” surgical technique with a shock index (S.I.) < 1.5. Methods Twelve patients who underwent PAS cesarean hysterectomy were included in the study. Results Group I had S.I. < 1.5, and group II had S.I. ≤ 1.5. Group I had more complications, but none were above Grade 3 or fatal. Preoperative scheduled uterine artery embolization did not result in serious complications, but three patients who had emergency common iliac artery balloon occlusion (CIABO) and a primary total hysterectomy with S.I. < 1.5 had postoperative Grade 2 thrombosis. Two patients underwent manual ablation of the placenta under CIABO to preserve the uterus, both with S.I. < 1.5. Conclusions The study found that the “Holding-up uterus” technique was safe, even in critical situations with S.I. < 1.5. CIABO had no intervention effect. The study also identified assisted reproductive technology pregnancies with a uterine cavity length of less than 5 cm before conception as a critical factor.
abstract_unstemmed	Abstract Background Placenta accreta spectrum (PAS) cesarean hysterectomy is performed under conditions of shock and can result in serious complications. This study aimed to evaluate the usefulness of the “Holding-up uterus” surgical technique with a shock index (S.I.) < 1.5. Methods Twelve patients who underwent PAS cesarean hysterectomy were included in the study. Results Group I had S.I. < 1.5, and group II had S.I. ≤ 1.5. Group I had more complications, but none were above Grade 3 or fatal. Preoperative scheduled uterine artery embolization did not result in serious complications, but three patients who had emergency common iliac artery balloon occlusion (CIABO) and a primary total hysterectomy with S.I. < 1.5 had postoperative Grade 2 thrombosis. Two patients underwent manual ablation of the placenta under CIABO to preserve the uterus, both with S.I. < 1.5. Conclusions The study found that the “Holding-up uterus” technique was safe, even in critical situations with S.I. < 1.5. CIABO had no intervention effect. The study also identified assisted reproductive technology pregnancies with a uterine cavity length of less than 5 cm before conception as a critical factor.
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title_short	Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study
url	https://doi.org/10.1186/s12893-024-02311-8 https://doaj.org/article/3a8c8dd36dc94c859d2739a16773ebdd https://doaj.org/toc/1471-2482
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author2	Makoto Orisaka Daisuke Inoue Hiroshi Kawamura Nozomu Takahashi Hideaki Tsuyoshi Akiko Shinagawa Tetsuji Kurokawa Yoshio Yoshida
author2Str	Makoto Orisaka Daisuke Inoue Hiroshi Kawamura Nozomu Takahashi Hideaki Tsuyoshi Akiko Shinagawa Tetsuji Kurokawa Yoshio Yoshida
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up_date	2024-07-04T02:08:04.233Z
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Evaluation of the holding-up uterus technique for placenta accreta spectrum cesarean hysterectomy in shocked patients with a high shock index: a case series study

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