@article{Yazdani_Zaheer_Amin_Mukhtar_2022, title={Focal Resection of Lower Uterine Segment for Morbidly Adherent Placenta. An Alternative to Obstetric Hysterectomy-(Better Modality with Better Outcome)}, volume={72}, url={https://pafmj.org/PAFMJ/article/view/5780}, DOI={10.51253/pafmj.v72i2.5780}, abstractNote={<p><strong>Objectives:</strong> To focus on the benefits of focal resection of the lower uterine segment as compared to obstetric hysterectomy in patients with morbidly adherent placenta.<br><strong>Study Design:</strong> Quasi-experimental study.<br><strong>Place and Duration of Study:</strong> Combined Military Hospital Okara, Oct 2019 to Nov 2020.<br><strong>Methodology:</strong> Fifty-two women between 34 to 38 weeks of gestation were operated for morbidly adherent placenta. Group-I women (focal resection of the lower uterine segment) and Group-II (obstetric hysterectomy) were twenty-six each. In Group-I, hemostasis was secured by a figure of 8 sutures, purse-string sutures or continuous sutures. In Group-II, hemostasis was secured, and internal iliac artery ligation was done as required. </p> <p><strong>Results:</strong> Group-I undergoing focal resection of lower uterine segment hemostasis was addressed by the figure of 8 sutures in 21 (80%) women and purse-string sutures in 7 women (27%). Hemostasis of the posterior uterine wall was done in 12 (47%) women. Balloon tamponade was used in 10 (40%) women and B-Lynch suture in 5 (20%) women. Internal iliac artery ligation was done in 4 (11%) women, and the bladder was injured in 10 (40%) women. Group-II undergoing obstetric hysterectomy hemostasis was secured for leftover placental tissue in 5 (18%) women, and internal iliac artery ligation was done in 9 (35%) women. Bladder repair was done in 12 (47%) cases. <br><strong>Conclusion:</strong> Although time-consuming, focal resection of the lower uterine segment and hemostasis are associated with less morbidity.</p>}, number={2}, journal={Pakistan Armed Forces Medical Journal}, author={Yazdani, Tehreem and Zaheer, Fareeha and Amin, Nabila and Mukhtar, Saad}, year={2022}, month={May}, pages={627–31} }