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

• 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.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2157-6998; 2157-7005; 10.1055/s-0038-1675848
• Keywords: fibrin patch; placenta accrete; morbidly adherent placenta; postpartum hemorrhage; cesarean; Gynecology and obstetrics; RG1-991
• Source: American Journal of Perinatology Reports, Vol 08, Iss 04, Pp e325-e327 (2018)

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.