Bladder lacerations in abnormal placental insertion
Cristina Buzgar, Tiberiu Gireada, Radu Mazilu, Irina Iliescu and Mircea Onofriescu
Arcadia Hospital, Romania
Cuza Voda Hospital Iasi, Romania
: Androl Gynecol: Curr Res
Abstract
Aim: To anticipate the risk of bladder lacerations based on risk factors, ultrasound and Doppler examination in patients with abnormal placental insertion and improve the neonatal and mother prognosis during and after birth. Patients & Methods: This study included 12 patients with placenta accreta that delivered by emergency C-section, complicated with bladder laceration and hysterectomy. Examinations were done in the Cuza Voda Obstetrics and Gynecology Hospital from October 2010 to December 2017. Results: Patients with a mean age of 28.4 years have had emergency C-sections between 31-37 weeks of gestation. Various risk factors such as previous C-sections, placenta previa, urological intervention during C-section, ultrasound and Doppler examination before birth, gestational age, associated pathologies of the mother were evaluated. Also, placental lacunae, loss of retro placental space, retro placental myometrial thickness, echogenic bladder wall and Doppler criteria were evaluated in 7 of 12 cases. Conclusion: Previous C-section is a major risk factor for placenta accreta. An ultrasound exam before birth and in some cases an MRI was extremely helpful in anticipation of possible urinary tract lacerations during C-section. The help of the urologist for bladder during surgery have led to faster post operatory recovery, the decrease of hospitalization and ICU time, and fewer cases of post operatory hematuria. Also, all patients (9) that were monitored by the doctor during pregnancy had delivered at more than 34 weeks of gestation, had better pre and postpartum hemoglobin level, and the babies had better weight and Apgar score at birth.
Biography
Cristina Buzgar has her expertise in ultrasonography, hysteroscopy and cervical pathology and passion in improving the wellbeing of the mother and baby during pregnancy. She has completed Medical school UMF GR. T. Popa, Iasi Romania (2011) and also a Fellowship in Santo Bambino Hospital, Department of Obstetrics and Gynecology, Catania, Sicily (2009). She went on to complete a Residency in Obstetrics and Gynecology at Cuza Voda Hospital Iasi, Romania (2017). Presently she works at Arcadia Private Hospital in Iasi, Romania as a Specialist Doctor. She has experience in research and teaching both in hospital and educational institutions. cristina.buzgar@gmail.com
