Editorial staff 27 September 2021 13:52
Share An urgent caesarean section was performed at the Cervello hospital on a pregnant patient who presented “an abnormality of placental implantation and signs of accretism and percretism” which led to a bladder invasion by the placenta. The patient – who had been sent to the Palermitan hospital from a provincial hospital – was hospitalized in an emergency regime in the Obstetrics and Gynecology ward of the Cervello hospital where she performed the entire diagnostic and instrumental procedure for the classification of the case and risk indices. In particular, the ultrasound evaluation showed a risk of classification of type PAS 3, or a bladder invasion by the placenta. The caesarean section was quickly scheduled (placenta accreta is defined as the condition in which the placenta is pathologically adherent to the uterus). The intervention involved a large multidisciplinary team, already created ad hoc in the Palermo company for some time, which on this point boasts a consolidated experience and advanced operating protocols, in line with the national scientific indications for this pathology, thus ranking among the major regional reference points for the treatment of these pathologies of pregnancy. In the last two years, in fact, the Cervello hospital has recorded a large number of patients affected by abnormal placental insertion. The caesarean section and the entire procedure – surgical, urological and radiological – were performed under epidural anesthesia, guaranteeing perfect hemodynamic stability of the patient and her active participation in the event of birth, even in such a difficult operative context. The intervention was developed in different steps in which each specialist performed the segment of their competence in perfect synergy with the other colleagues and the multidisciplinary approach was once again successful, despite the operational complexities that arose, some of the which are very severe, such as bladder bleeding perfectly controlled and resolved by the team. The entire procedure, planning and management of the caesarean section involved Giuseppe Cali ‘, Vincenzo Lo Bue and Salvatore Polito Gynecologists and Antonella Tripiedi Obstetrician / instrumentalist of Gynecology and Obstetrics, directed by Gaspare Cucinella. Also involved are Francesco Tarantino and Antonella Lo Scrudato, anesthesiologists of Anesthesia and Intensive Care, directed by Baldassare Renda; Gioacchino Di Baudo, Interventional radiologist and Paolo Di Marco of the Radiology unit, directed by Fabio Gioia; Cristina Scalici Gesolfo Urologist of Urology, directed by Fulvio Piazza, Mario Tumminello Neonatologist at Utin, directed by Fabio Giardina; and again: Gilberto Cappadoro, Concetta Ferreri, Ignazio Guarrato, Sonia Cangemi and Giuseppe Tamburello nurses / instrumentalists of Obstetrics and Gynecology. After the operation, a period of observation and control of vital parameters was arranged for mother and child. For the mother, post-operative pain control was ensured through the epidural catheter. Due to its degree of prematurity, the child was entrusted to our NICU where neonatologists have constantly reported a normal course without complications. Mom and baby are fine today. “A result – comments the general manager of Villa Sofia-Cervello in Palermo, Walter Messina, together with the strategic direction – which is due to the synergy and skills of the entire hospital team which, thanks to consolidated training, can boast highly qualified and in line with the highest European standards. This allows our specialists to face this rare and complex pathology of pregnancy in total safety, confirming its high professionalism “.
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