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

AJP Rep. 2018 Oct;8(4):e325-e327. doi: 10.1055/s-0038-1675848. Epub 2018 Nov 14.

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.

Keywords: cesarean; fibrin patch; morbidly adherent placenta; placenta accrete; postpartum hemorrhage.

Publication types

  • Case Reports