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Staged treatment of placenta accreta spectrum: A combined surgical and radiological approach.
- Source :
-
Australian & New Zealand Journal of Obstetrics & Gynaecology . Jun2023, Vol. 63 Issue 3, p372-377. 6p. - Publication Year :
- 2023
-
Abstract
- Background: Placenta accreta spectrum (PAS) is a rare but serious complication of pregnancy. Aims: The aim of this study was to determine maternal and neonatal outcomes following a combined surgical and interventional radiology (IR) approach to managing PAS, and the risks associated with this technique. Methods and Materials: Retrospective cohort study of all cases of PAS in a tertiary maternity centre between January 2001 and July 2020. Women who underwent caesarean hysterectomy for histologically confirmed PAS with a staged surgical and IR approach were compared with those who underwent caesarean hysterectomy without IR. Maternal, neonatal outcomes, surgical and radiological complications were assessed. Results: Forty‐six women were included in the study, and 30/46 (65.2%) underwent the staged surgical and IR approach. Women in the staged group had less overall blood loss (1794 mL vs 3713 mL; P < 0.001), less requirement for blood transfusion (40% vs 75%; P < 0.001), and a lower mean volume of packed red cells transfused (2.5 vs 6.1 units). Anaesthetic and operative times were longer for the staged group (468 vs 189 min: 272 vs 141 min P < 0.001), respectively. There were no differences in rates of neonatal or maternal complications between the two groups. Conclusion: This study demonstrates that a staged procedure combining surgery and IR for PAS results in a considerable reduction in blood loss, need for transfusion, and units of packed red cells transfused compared with surgery alone. The staged procedure required significantly longer anaesthetic and operative times; however, there were no differences in maternal and neonatal morbidity. [ABSTRACT FROM AUTHOR]
- Subjects :
- *HYSTERECTOMY
*OPERATIVE surgery
*INTERVENTIONAL radiology
*RETROSPECTIVE studies
*TERTIARY care
*MANN Whitney U Test
*LOCAL anesthesia
*PLACENTA accreta
*PREGNANCY outcomes
*COMPARATIVE studies
*PEARSON correlation (Statistics)
*CHI-squared test
*CESAREAN section
*DATA analysis software
*RARE diseases
*LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 00048666
- Volume :
- 63
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Australian & New Zealand Journal of Obstetrics & Gynaecology
- Publication Type :
- Academic Journal
- Accession number :
- 164421527
- Full Text :
- https://doi.org/10.1111/ajo.13646