Transverse uterine fundal incision for placenta previa accreta in the anterior wall

我们开发了一种手术技术，使用子宫底横向切口分娩前置胎盘在子宫前壁的婴儿，可能胎盘植入。这种手术方法克服了与先前手术方法相关的缺点：胎盘切开导致的胎儿出血和盲目手动移除胎盘。这种技术提供了以下好处。1)胎儿可以在没有任何压力的情况下分娩，因为可以完全避免切开胎盘。此外，从最高部位（通常是臀位）的尖端分娩既安全又简单。2)子宫腔内部可见，并且可以在操作者的完全视野下进行胎盘移除的试验。3)在整个手术过程中，子宫肌层伤口的出血可以停止。4)如果宫腔视野狭窄，可以扩大子宫壁切口，而不增加子宫肌层的横切面。5)胎盘床的出血点很明显。因此，精确止血是可能的。与以往报道的手术方法相比，这种手术方法对母儿安全，对手术者压力小。

We developed an operative technique using a transverse uterine fundal incision to deliver infants in cases of placenta previa in the anterior uterine wall, with possible placenta accreta. This operative method overcomes the drawbacks associated with previous operative methods : fetal bleeding resulting from placental incision and blind manual removal of the placenta. This technique offers the following benefits. 1) The fetus can be delivered without any stress because incision into the placenta can be avoided perfectly. In addition, delivery from the apex of the highest part(usually breech) is both safe and simple. 2) The uterine cavity interior is visible and the trial of the placental removal can be done in full vision of the operator. 3) Throughout the procedure, bleeding from the myometrial wound can be stopped. 4) The uterine-wall incision can be extended without adding a cross section to the myometrium if the view of the uterine cavity is narrow. 5) The bleeding point from the placental bed is directly apparent. For that reason, precise hemostasis is possible. This operative method is much safer for mother and fetus and less stressful for operator than previously reported operative methods.