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Peripartum Robotic-Assisted Laparoscopic Hysterectomy After Second-Trimester Pregnancy Loss With Placenta Increta

Boes, Stephanie MD; Mahdi, Haider MD; Khoury, Fadi MD; Kebria, Mehdi Moslemi MD

doi: 10.1097/AOG.0b013e3182998ec5
Case Reports

BACKGROUND: Peripartum hysterectomy is performed for a variety of indications, including abnormal placentation, retained placenta, uterine rupture, and uterine atony. Most cases are emergent and performed through open laparotomy.

CASE: At 20 weeks of gestation, a patient with previous endometrial ablation had ruptured membranes and delivered her fetus but not her placenta. She was hemodynamically stable and underwent robotic hysterectomy. Surgical pathology confirmed placenta increta.

CONCLUSION: In appropriate patients, a minimally invasive approach may be considered for peripartum hysterectomy to potentially decrease maternal morbidity.

Supplemental Digital Content is Available in the Text.A robotic-assisted laparoscopic approach may be considered in hemodynamically stable patients when peripartum hysterectomy is indicated.

Divisions of Maternal Fetal Medicine and Gynecologic Oncology, Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio.

Corresponding author: Stephanie Boes, MD, Department of Obstetrics and Gynecology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195; e-mail: stephanieboes@gmail.com.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2013 by The American College of Obstetricians and Gynecologists.