Outcomes of Conservative Management for Decreasing Blood Loss in Cases Placenta Accreta Spectrum Disorders (PAS): A Meta-Analysis and Systematic Review | ||||
| Evidence Based Women's Health Journal | ||||
| Volume 15, Issue 15, January 2025, Page 1-9 PDF (921.22 K) | ||||
| Document Type: Review Article | ||||
| DOI: 10.21608/ebwhj.2024.340683.1395 | ||||
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| Authors | ||||
Eman Mojahed  1; Hagar M. Mohamed2; Ahmed E. Abd El Tawwab2
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| 1Department of obstetrics and gynecology , faculty of medicine, Fayoum university | ||||
| 2Department of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Egypt | ||||
| Abstract | ||||
| Background: While conservative therapy has been employed in many medical centers for placenta accreta spectrum (PAS) cases, cesarean hysterectomy, a conventional therapeutic procedure for PAS, has been linked to significant morbidity. Objective: Is to assess the outcomes for mothers with placenta accreta spectrum diseases who received conservative surgical management versus those who underwent cesarean (CS) hysterectomy. Methods: Up until September 2024, a thorough research screening was performed in MEDLINE, Pubmed, Google scholar, EMBASE, and WOS. Studies that compared and reported pertinent maternal outcomes in cases with PAS based on conservative care or cesarean (CS) hysterectomy were required. Results: The meta-analysis contained eight studies. PAS women undergoing conservative management demonstrated a significant statistical difference between the two treatment options in terms of blood loss, transfusion volume, and operative time when weighed against those undergoing cesarean hysterectomy, with a summarized standardized mean difference (SMD) was -1.34 with a 95% CI (-1.95 - -0.73) , (-1.05 with a 95% CI -1.47 - -0.64) & (-1.61 with a 95% CI -3.19 - -0.03), respectively. Additionally, conservative treatment required less operative time, and had lower possibility of urinary bladder damage, ICU admission, and DIC. However, they also had higher probability of infection (endometritis) and for being readmitted. Conclusion: When cases with PAS choose to keep their uterus intact and are aware of the constraints of conservative care, it may be a good substitute for a cesarean hysterectomy. | ||||
| Keywords | ||||
| Conservative treatment; blood loss; hysterectomy; maternal outcomes; placenta accrete | ||||
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