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

Abstract 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 cesa...

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Bibliographic Details
Main Authors: James A. Greenberg (Author), Julian N. Robinson (Author), Jean M. Carabuena (Author), Michaela K. Farber (Author), Daniela A. Carusi (Author)
Format: Book
Published: Thieme Medical Publishers, Inc., 2018-10-01T00:00:00Z.
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Summary:Abstract 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.
Item Description:2157-6998
2157-7005
10.1055/s-0038-1675848