AI Article Synopsis
- The study assessed the effectiveness and safety of local uterine resection versus hysterectomy in patients with placenta accreta spectrum (PAS).
- Patients undergoing hysterectomy experienced significantly more blood loss, required more blood transfusions, and had a higher rate of intensive care unit admissions compared to those who received local resection.
- The findings suggest that local resection can be a safer option for selected PAS cases, potentially reducing complications and improving patient outcomes.
Article Abstract
Objective: Placenta accreta spectrum (PAS) is a potentially life-threatening condition characterized by the abnormal adherence of the placenta to the implantation site. We sought to evaluate the efficacy, surgical feasibility, risks, and advantages of local uterine resection in cases complicated with PAS.
Materials And Methods: This study included 97 patients with PAS, which was confirmed during surgery and by histopathological examination between January 2013 and December 2019. The patients were divided into two groups based on operative approach. The study population (local resection group) consisted of 30 cases in whom total resection of adherent placenta and myometrium was performed, whereas the control group (hysterectomy group) of 67 cesarean hysterectomy cases.
Results: Patients who underwent hysterectomy had significantly more bleeding than the local resection group (1180±160 mL vs 877±484 mL; p=0.002). The mean number of transfused packed red blood cells (pRBCs) was greater in the hysterectomy group (4.5±2.3) than in the local resection group (2.6±3.1; p=0.001). Transfusion rate of four and/or more pRBCs was 67.2% in the hysterectomy group and 33.3% in the local resection group, which indicated a statistically significant difference (p=0.002). Of patients, 29.6% required intensive care unit in the hysterectomy group and 6.7% in the local resection group (p=0.023).
Conclusion: Local resection can be performed safely in selected PAS cases. In these cases, using a standardized protocol in terms of patient selection and surgical procedure will reduce morbidity and mortality.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7406901 | PMC |
| http://dx.doi.org/10.4274/tjod.galenos.2020.82652 | DOI Listing |
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