Lateral versus central approach in dissecting urinary bladder during cesarean section in placenta accreta spectrum: case control study | ||||
| Minia Journal of Medical Research | ||||
| Articles in Press, Accepted Manuscript, Available Online from 18 February 2024 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mjmr.2024.259907.1636 | ||||
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| Authors | ||||
Minia Badr  1; heba hassan ahmed2; Saad El Gelany 3; Mostafa Kamal4
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| 1Obstetric and Gynecology department, Faculty of Medicine, Minia University | ||||
| 2Obstetrics and gynecology department, faculty of medicine, minia university, minia, Egypt | ||||
| 3Obstetrics and Gynecology, Faculty of Medicine – Minia University, Egypt. | ||||
| 4obstetrics and gynecology, faculty of medicine, minia university | ||||
| Abstract | ||||
| Injury of the urinary bladder is a prevalent complication associated with cesarean sections. Multiple cesarean sections, placenta previa (PP), and any form of Placenta accreta spectrum (PAS) disorders are recognized as a significant risk factors for urinary tract injuries after cesarean birth. Aim: To compare the urological outcomes of lateral and classical central urinary bladder dissection, in placenta previa and PAS cases. Methods: A case controlled study included patients suspected to be PAS disorders based upon ultrasound findings (2D and color Doppler ultrasound) was conducted. All recruited patients were subjected to caesarian delivery with 2 modalities of bladder dissection; central and lateral approaches. Results: A total of 111 pregnant women suspected with PAS disorders were recruited; 85 females had central and 26 had lateral bladder dissection. Eighty-seven of our patients were placenta previa and 24 were PAS cases; 71-cases with PP were subjected to central bladder dissection and 16 had lateral approach while the placenta accrete cases; 14 had central approach and 10 had the lateral approach of bladder dissection. The urinary system injuries among the PP group was 17% among central group in comparison to 0% among the lateral group with a significant difference between them (P=0.021*). While the urinary system injuries among the placenta accrete group was 21.4% among the central group and 20% among the lateral approach group with no significance between them. Conclusion: Lateral approach of bladder dissection may reduce the incidence of urinary system injuries among PP cases and of lower significance among PAS. | ||||
| Keywords | ||||
| Placenta accrete spectrum; urinary bladder dissection; lateral approach | ||||
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