A 5-year experience on perinatal outcome of placenta accreta spectrum disorder managed by cesarean hysterectomy in southern Iranian women.

Autor: Kasraeian M; Department of Obstetrics and Gynecology, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Zand Avenue, Shiraz, Iran.; Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran., Hashemi A; Department of Obstetrics and Gynecology, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Zand Avenue, Shiraz, Iran.; Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.; Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran., Hessami K; Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.; Professor Alborzi Clinical Microbiology Research Center and Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran., Alamdarloo SM; Department of Obstetrics and Gynecology, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Zand Avenue, Shiraz, Iran. shaghayeghmoradi84@gmail.com.; Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. shaghayeghmoradi84@gmail.com.; Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. shaghayeghmoradi84@gmail.com., Vahdani R; Department of Obstetrics and Gynecology, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Zand Avenue, Shiraz, Iran., Vafaei H; Department of Obstetrics and Gynecology, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Zand Avenue, Shiraz, Iran.; Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran., Najib FS; Department of Obstetrics and Gynecology, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Zand Avenue, Shiraz, Iran.; Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran., Shiravani Z; Department of Obstetrics and Gynecology, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Zand Avenue, Shiraz, Iran., Razavi B; Department of Obstetrics and Gynecology, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Zand Avenue, Shiraz, Iran., Homayoon N; Department of Obstetrics and Gynecology, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Zand Avenue, Shiraz, Iran., Nayebi M; Department of Obstetrics and Gynecology, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Zand Avenue, Shiraz, Iran., Bazrafshan K; Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran., Jahromi MA; Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.; Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran.
Jazyk: angličtina
Zdroj: BMC women's health [BMC Womens Health] 2021 Jun 15; Vol. 21 (1), pp. 243. Date of Electronic Publication: 2021 Jun 15.
DOI: 10.1186/s12905-021-01389-z
Abstrakt: Background: We aimed to investigate the risk factors of placenta accreta spectrum (PAS) disorder, management options and maternal and neonatal outcomes of these pregnancies in a resource-limited clinical setting.
Methods: All women diagnosed with placenta accreta, increta, and percreta who underwent peripartum hysterectomy using a multidisciplinary approach in a tertiary center in Shiraz, southern Iran between January 2015 until October 2019 were included in this retrospective cohort study. Maternal variables, such as estimated blood loss, transfusion requirements and ICU admission, as well as neonatal variables such as, Apgar score, NICU admission and birthweight, were among the primary outcomes of this study.
Results: A total number of 198 pregnancies underwent peripartum hysterectomy due to PAS during the study period, of whom163 pregnancies had antenatal diagnosis of PAS. The mean gestational age at the time of diagnosis was 26 weeks, the mean intra-operative blood loss was 2446 ml, and an average of 2 packs of red blood cells were transfused intra-operatively. Fifteen percent of women had surgical complications with bladder injuries being the most common complication. Furthermore, 113 neonates of PAS group were admitted to NICU due to prematurity of which 15 (7.6%) died in neonatal period.
Conclusion: Our findings showed that PAS pregnancies managed in a resource-limited setting in Southern Iran have both maternal and neonatal outcomes comparable to those in developed countries, which is hypothesized to be due to high rate of antenatal diagnosis (86.3%) and multidisciplinary approach used for the management of pregnancies with PAS.
Databáze: MEDLINE
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