The characteristics of the course of pregnancy and surgical management in placenta increta in patients with reproductive tract malformations
- Authors: Mikheeva A.A.1, Yarygina T.A.2, Shmakov R.G.1, Nizyaeva N.V.3, Amiraslanov E.Y.1, Karapetyan T.E.1, Rogachevskiy O.V.1, Pyregov A.V.1
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Affiliations:
- Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
- A.N. Bakulev National Medical Research Center of Cardiovascular Surgery, Ministry of Health of Russia
- Research Institute of Human Morphology
- Issue: No 9 (2022)
- Pages: 146-154
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/249588
- DOI: https://doi.org/10.18565/aig.2022.9.146-154
- ID: 249588
Cite item
Open Access
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Abstract
Background: The impact of congenital uterine malformations on reproductive outcomes remains a highly controversial issue in the modern world. In patients with an internal genital malformation, the frequency of spontaneous abortions, premature detachment of a normally located placenta, premature delivery, and fetal death is increased; the risk of placenta increta is also higher in this category of women. In connection with the above, it seems relevant to analyze the course of pregnancies, surgical tactics, and outcomes in case of abnormal placental invasion in patients with a uterine malformation, as well as to compare the authors’ own experience with foreign data on the concurrence of these pathologies. Case report: In the foreign sources, there are 4 cases of placenta increta in uterine malformations, each of which was accompanied by substantial blood loss requiring hysterectomy. A full-term baby was born only in 1 of the presented cases; 2 cases of antenatal fetal death occurred; one baby was born alive at 28 weeks’ gestation. It is important to note that abnormal placental invasion was not diagnosed until the onset of pain or bleeding in 3 of the published cases. The authors describe Russia’s first clinical case of pregnancy resulting from in vitro fertilization in a patient with a reproductive tract malformation and antenatally diagnosed placental ingrowth into the area of a postoperative uterine scar. Conclusion: Due to the timely diagnosis ofabnormal placental invasion, correct patient routing, a multidisciplinary approach to pregnancy management, and a proven technique of organ-sparing surgery for placenta increta, it was possible to bring the pregnancy to full term, to perform organ-sparing surgery using blood-saving technologies.
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About the authors
Alexandra A. Mikheeva
Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: shuratora@mail.ru
postgraduate student
Tamara A. Yarygina
A.N. Bakulev National Medical Research Center of Cardiovascular Surgery, Ministry of Health of Russia
Email: tamarayarygina@gmail.com
PhD, specialist of ultrasound diagnostics, researcher at the Perinatal Cardiology Center
Roman G. Shmakov
Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: r_shmakov@oparina4.ru
Dr. Med. Sci., Professor, Director of the Institute of Obstetrics
Natalia V. Nizyaeva
Research Institute of Human Morphology
Email: niziaeva@gmail.com
Dr. Med. Sci., Head of the Reproduction Pathology Laboratory
Elrad Yu. Amiraslanov
Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: eldis@mail.ru
PhD, Head of the Department of Obstetrics
Tamara E. Karapetyan
Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: tomamed02@mail.ru
Dr. Med. Sci., doctor at the Department of Obstetrics
Oleg V. Rogachevskiy
Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: о_rogachevskiy@oparina4.ru
Dr. Med. Sci., Head of the Department of Extracorporal Methods of Treatment and Detoxification, Professor at the Department of Anesthesiology and Resuscitation
Aleksey V. Pyregov
Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: pyregov@oparina4.ru
Dr. Med. Sci., Director of the Institute of Anesthesiology and Intensive Care
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