Volume 11, Issue 2 (2026)
SJMR 2026, 11(2): 99-104 |
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Saremi A, Minfendereski A, Nateghi M R. Removal of an Adherent Placenta from the Uterine Fundus Using Temporary Uterine Inversion with Uterine Preservation Following Cesarean Delivery: A Case Report. SJMR 2026; 11 (2) : 8
URL: http://saremjrm.com/article-1-402-en.html
URL: http://saremjrm.com/article-1-402-en.html
1- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran. & Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran.
Abstract: (25 Views)
Introduction: Abnormal placental adherence to the uterine wall can be associated with failure of placental separation, hemorrhage, and the need for complex surgical interventions during delivery. In severe cases, preservation of the uterus may be challenging. In such circumstances, selecting an appropriate surgical approach to control hemorrhage and remove the adherent tissue while preserving the uterus is of particular importance. In this report, a surgical technique based on temporary uterine inversion was used to provide direct access to the site of placental adherence at the uterine fundus and facilitate uterine preservation at Sarem Super Specialty Hospital, Tehran.
Case Presentation: A 54-year-old woman with a history of one previous cesarean delivery conceived through in vitro fertilization (IVF) using a donated embryo and had a singleton pregnancy. The pregnancy was complicated by edema, hypertension, and cervical insufficiency, for which the patient received medical treatment and underwent cervical cerclage. At 36 weeks of gestation, she underwent cesarean delivery because of pain, and a neonate in good general condition was delivered. Following delivery, due to incomplete placental separation and adherence of part of the placenta to the uterine fundus, temporary uterine inversion was performed to provide access to the site of placental adherence, with the aim of preserving the uterus. After removal of the adherent tissue, control of hemorrhage, and repair of the affected area, the uterus was restored to its normal position and was successfully preserved without the need for hysterectomy or blood transfusion.
Conclusion: This case demonstrates that, in selected cases of placental adherence to the uterine fundus in which direct access to the site of adherence is difficult and uterine preservation is desired, temporary uterine inversion may provide improved visualization and access to the adherent area, facilitate removal of adherent tissue, control hemorrhage, and repair of the endometrial surface. In the present case, this approach allowed successful uterine preservation without the need for hysterectomy or blood transfusion. Given that this report describes a single case, further studies are warranted to evaluate the efficacy and safety of this technique.
Case Presentation: A 54-year-old woman with a history of one previous cesarean delivery conceived through in vitro fertilization (IVF) using a donated embryo and had a singleton pregnancy. The pregnancy was complicated by edema, hypertension, and cervical insufficiency, for which the patient received medical treatment and underwent cervical cerclage. At 36 weeks of gestation, she underwent cesarean delivery because of pain, and a neonate in good general condition was delivered. Following delivery, due to incomplete placental separation and adherence of part of the placenta to the uterine fundus, temporary uterine inversion was performed to provide access to the site of placental adherence, with the aim of preserving the uterus. After removal of the adherent tissue, control of hemorrhage, and repair of the affected area, the uterus was restored to its normal position and was successfully preserved without the need for hysterectomy or blood transfusion.
Conclusion: This case demonstrates that, in selected cases of placental adherence to the uterine fundus in which direct access to the site of adherence is difficult and uterine preservation is desired, temporary uterine inversion may provide improved visualization and access to the adherent area, facilitate removal of adherent tissue, control hemorrhage, and repair of the endometrial surface. In the present case, this approach allowed successful uterine preservation without the need for hysterectomy or blood transfusion. Given that this report describes a single case, further studies are warranted to evaluate the efficacy and safety of this technique.
Article number: 8
Keywords: : Placental Adherence, Uterine Fundus, Adherent Placenta, Uterine Inversion, Uterine Preservation, Cesarean Delivery, Case report.
Article Type: Case Report |
Subject:
Childbirth
Received: 2026/08/1 | Accepted: 2026/08/16 | Published: 2026/08/25
Received: 2026/08/1 | Accepted: 2026/08/16 | Published: 2026/08/25
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