Local uterine resection with Bakri balloon placement in placenta accreta spectrum disorders
Journal Title: Turkish Journal of Obstetrics and Gynecology - Year 2020, Vol 17, Issue 2
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.
Authors and Affiliations
Emin Üstünyurt
Keywords
Related Articles
- EP ID EP685114
- DOI 10.4274/tjod.galenos.2020.82652
- Views 161
- Downloads 0
Patients’ perceptions toward and the driving factors of decision-making for opportunistic bilateral salpingectomy at the time of cesarean section
Objective: Enough data can be found in the literature regarding the protective effect of tubal ligation on gynecological cancers. In addition, a large body of evidence revealed that prophylactic bilateral salpingectomy h...
Fetal nuchal translucency: is there an association with birthweight and neonatal wellbeing?
Objective: To evaluate the relationship between nuchal translucency (NT) values with birthweight and the wellbeing of the newborn. Materials and Methods: This retrospective cohort study that included 508 patients made u...
Role of less commonly agreed risk factors on disease recurrence in endometrial cancer: a propensity score-matched comparison
Objective: To compare the clinicopathologic features of patients with endometrial cancer (EC) with recurrent disease with a primary surgery, stage, grade, and tumor histotype-matched cohort of patients without recurrence...
The predictive value of weight gain and waist circumference for gestational diabetes mellitus
Objective: The first objective of this study was to investigate the relationship between gestational diabetes mellitus (GDM) and gestational weight gain (WG), waist circumference (WC), prepregnancy, and gestational body...
Pregnancy associated plasma protein A: An indicator of adverse obstetric outcomes in a South India population
Objective: First trimester aneuploidy screening (FTAS) has become an integral part of antenatal care in most of centers in India. The serum markers used for FTAS are pregnancy-associated plasma protein A (PAPP-A) and bet...