Volume 20, Issue 9 (September 2022)
IJRM 2022, 20(9): 739-744 |
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Razieh Mohammad Jafari1 
, Mahin Najafian1 , Mojgan Barati1 , Najmieh Saadati1 , Zorvan Jalili2 , Atefeh Poolad * 3
, Mahin Najafian1 , Mojgan Barati1 , Najmieh Saadati1 , Zorvan Jalili2 , Atefeh Poolad * 3
1- Department of Obstetrics and Gynecology, School of Medicine, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
2- Department of Obstetrics and Gynecology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
3- Department of Obstetrics and Gynecology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. , atefehpoolad14@gmail.com
2- Department of Obstetrics and Gynecology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
3- Department of Obstetrics and Gynecology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. , atefehpoolad14@gmail.com
Abstract: (796 Views)
Background: Placenta accreta spectrum (PAS) is a major cause of obstetric bleeding in third trimester of pregnancy.
Objective: This study aimed to compare the outcomes of uterine preservation surgery vs. hysterectomy in women with PAS.
Materials and Methods: In this retrospective cross-sectional study, the records of 68 women with PAS referred to the Imam Khomeini hospital in Ahvaz, Iran, between March 2015 and February 2020 were included. The women divided into 2 groups according to surgical approach: hysterectomy vs. uterine preservation (including just removing the lower segment, removing the lower segment with uterine artery ligation or removing the lower segment with hypogastric artery ligation during cesarean section). The need for blood components transfusion (whole blood, packed cells, and fresh frozen plasma), maternal mortality, duration of surgery, and length of hospitalization was compared between groups.
Results: In total, we investigated 68 women between the ages of 24-45 yr (mean age of 32.88 ± 5.08 yr). All participants were multiparous and underwent cesarean section. Furthermore, 28 women (41.2%) had a history of curettage. In total, 24 women (35.3%) underwent hysterectomy, and 44 (64.7%) underwent uterine preservative surgeries. There were no significant differences between groups of hysterectomy and uterine preservative surgeries in terms of need for blood components transfusion, maternal mortality, duration of surgery, and length of hospitalization.
Conclusion: The results of this study showed no significant difference between groups regarding the studied outcomes. Therefore, conservative surgeries could be used to preserve the uterus instead of hysterectomy in women with PAS.
Objective: This study aimed to compare the outcomes of uterine preservation surgery vs. hysterectomy in women with PAS.
Materials and Methods: In this retrospective cross-sectional study, the records of 68 women with PAS referred to the Imam Khomeini hospital in Ahvaz, Iran, between March 2015 and February 2020 were included. The women divided into 2 groups according to surgical approach: hysterectomy vs. uterine preservation (including just removing the lower segment, removing the lower segment with uterine artery ligation or removing the lower segment with hypogastric artery ligation during cesarean section). The need for blood components transfusion (whole blood, packed cells, and fresh frozen plasma), maternal mortality, duration of surgery, and length of hospitalization was compared between groups.
Results: In total, we investigated 68 women between the ages of 24-45 yr (mean age of 32.88 ± 5.08 yr). All participants were multiparous and underwent cesarean section. Furthermore, 28 women (41.2%) had a history of curettage. In total, 24 women (35.3%) underwent hysterectomy, and 44 (64.7%) underwent uterine preservative surgeries. There were no significant differences between groups of hysterectomy and uterine preservative surgeries in terms of need for blood components transfusion, maternal mortality, duration of surgery, and length of hospitalization.
Conclusion: The results of this study showed no significant difference between groups regarding the studied outcomes. Therefore, conservative surgeries could be used to preserve the uterus instead of hysterectomy in women with PAS.
Keywords: Placenta accreta, Placenta diseases, Pregnancy complications, Conservative treatment, Hysterectomy.
Type of Study: Original Article |
Subject:
Pregnancy Health
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