Urinary tract injuries during cesarean section in patients with morbid placental adherence: retrospective cohort study.

Autor:	Alanwar A; a Ain Shams Maternity Hospital, Faculty of Medicine , Ain Shams University , Cairo , Egypt., Al-Sayed HM; a Ain Shams Maternity Hospital, Faculty of Medicine , Ain Shams University , Cairo , Egypt., Ibrahim AM; a Ain Shams Maternity Hospital, Faculty of Medicine , Ain Shams University , Cairo , Egypt., Elkotb AM; a Ain Shams Maternity Hospital, Faculty of Medicine , Ain Shams University , Cairo , Egypt., Abdelshafy A; a Ain Shams Maternity Hospital, Faculty of Medicine , Ain Shams University , Cairo , Egypt., Abdelhadi R; a Ain Shams Maternity Hospital, Faculty of Medicine , Ain Shams University , Cairo , Egypt., Abbas AM; b Faculty of Medicine , Assiut University , Assiut , Egypt., Abdelmenam HS; c Faculty of Medicine , Al Azhar University , Cairo , Egypt., Fares T; c Faculty of Medicine , Al Azhar University , Cairo , Egypt., Nossair W; d Faculty of Medicine , Zagazik University , Zagazik , Egypt., Abdallah AA; e Faculty of Medicine , Minia University , Minia , Egypt., Sabaa H; a Ain Shams Maternity Hospital, Faculty of Medicine , Ain Shams University , Cairo , Egypt., Nawara M; a Ain Shams Maternity Hospital, Faculty of Medicine , Ain Shams University , Cairo , Egypt.
Jazyk:	angličtina
Zdroj:	The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2019 May; Vol. 32 (9), pp. 1461-1467. Date of Electronic Publication: 2017 Dec 03.
DOI:	10.1080/14767058.2017.1408069
Abstrakt:	Background/objective: The purpose of this study is to evaluate the cases of lower urinary tract injuries during cesarean section with or without hysterectomy in cases with morbid placental adherence. Methods: This record based retrospective study was conducted at Ain Shams University Maternity Hospital in Cairo, Egypt during the period between January 2014 and December 2016. It included all patients who had urinary tract injuries during cesarean section with or without hysterectomy in the cases with morbid placental adherence and they were collected from files of pregnant women who were admitted at hospital planned for termination of pregnancy. Patients were enrolled in four groups, Group 1: cases without urinary tract injuries. Group 2: cases with injuries to the bladder. Group 3: cases with injuries of the ureter. Group 4: cases with injuries to the bladder and ureter. Results: This study gave us new information about the incidence of urinary tract injuries during cesarean section with morbid adherence placenta was 21.7% (Bladder 11.7%, Ureter 4.7%, and bladder with ureter 5.3%). There were various types of repair of urinary tract injury, as the following, bladder repair 10.8%, ureteric catheterization 0.9%, ureterovesical repair or reimplantation 1.5%, bladder repair and ureterovesical 1.2%, bladder repair and ureteric catheterization 2.3%, ureteric catheterization and ureterovesical 1.5 and 6.4% of cases needed urologic consultations. There is a real relation between urinary tract injury and obesity (55.3%). Bladder invasion was found in only 26.9% of all cases according to sonography findings. Most of the cases were delivered by cesarean section in 67.5%, and the remainders were delivered by cesarean hysterectomy 32.5%. About 96.5% of cases needed a blood transfusion. Conclusions: The morbid adherent placenta is still a challenge, which faces us as obstetricians, due to high morbidity and mortality. A multidisciplinary team is mandatory to avoid complications.
Databáze:	MEDLINE
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