Journal of Ultrasound in Medicine, Vol 1, Issue 8 311-314, Copyright © 1982 by American Institute of Ultrasound in Medicine
Sonographic placental localization in the determination of the site of uterine incision for placenta previa
F. H. Boehm, A. C. Fleischer and J. M. Barrett
The presence of a placenta previa is associated with increased maternal and
fetal morbidity. Hemorrhage is considered the primary underlying factor
contributing to this increased morbidity. Patients who have a placenta
previa are often hypovolemic and are therefore at high risk for hemorrhagic
shock if intraoperative blood loss during cesarean section is not
minimized. The authors reviewed sonographic localization of the placenta
prior to cesarean section for placenta previa, in order to facilitate
proper selection of uterine incision based on placental site and so reduce
intraoperative blood loss. Nineteen cases of placenta previa were reviewed.
Seventeen patients underwent a conventional low cervical or classic
incision, whereas two underwent paramedian uterine incision. Data from
these cases suggest that in patients who wish to be sterilized and in whom
the site of placental implantation is directly beneath the lower uterine
segment, as well as extending to an area in which a traditional classic
cesarean section would be made, a paramedian incisional technique is of
value.
