Maternal Outcome in Conservative Surgery versus Hysterectomy in Placenta Accreta Spectrum | ||||
| The Egyptian Journal of Fertility of Sterility | ||||
| Article 4, Volume 28, Issue 2 - Serial Number 11106352, March 2024, Page 17-26 PDF (5.06 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/egyfs.2024.349372 | ||||
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| Authors | ||||
Doaa Fahmi Mounir Abdou  1; Mohamed Hassan Hussien Bedairy2; Mona Gad Mostafa Elebeidy2; Moustafa Hassan Abd-Elhameed2; Mahmoud Mohamed Awad2
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| 1Department of Obstetrics and Gynecology Temai Elamdid Hospital Alazher Faculty of Medicine Mansoura, Egypt | ||||
| 2Mansoura University Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt | ||||
| Abstract | ||||
| Objective: to determine maternal outcome with conservative surgery versus hysterectomy in pregnant women with placenta accreta spectrum according to operative time, intraoperative blood loss, need for blood transfusion, postoperative complications, and hospital stay. Design: prospective cross section study. Setting: Mansoura University Hospitals. Patients : 100 pregnant women with a diagnosis of placenta accrete spectrum who underwent conservative surgery and hysterectomy in the Department of Obstetrics and Gynecology, Mansoura University Hospitals. Interventions: Patients were divided into two groups; group 1 (n = 50) conservative and group 2 (n =50) hysterectomy at 1:1 ratio. Measurements and Main Results: There was a highly significant difference among both groups as regards operative time, need for blood products transfusion, blood loss, hemoglobin assessment after surgery, and postoperative complications. In conservative group, the mean operative time (min) was 140.70 ± 54.986, packed RBCs units was 2.86 ± 1.750, plasma units were 1.62 ± 1.510, blood loss 1580 ± 321 ml, mean hemoglobin before and after surgery was 10.71 ± 0.835 and 10.12 ± 0.779, and none had Bladder injury. In hysterectomy group, the mean operative time (min) was 267.60 ± 48.469, packed RBCs units was 5.94 ± 2.683, plasma units were 5.22 ± 2.613, and blood loss 2343 ± 665.4 ml, mean hemoglobin before and after surgery was 10.66 ± 0.616 and 9.72 ± 0.856, and 10% had Bladder injury. Conclusions: conservative surgery (preservation of the uterus) is a suitable treatment of placenta accrete spectrum especially in communities like Egypt in which women want to preserve fertility and refuse hysterectomy but the woman must be diagnosed during pregnancy and admitted before surgery to tertiary care hospital to be operated under care of multidisciplinary team expert in dealing with this condition with possibility of hysterectomy if needed. | ||||
| Keywords | ||||
| Keywords: Placenta Accreta Spectrum (PAS); Hysterectomy; Conservative Surgery; Maternal Outcomes; Risk Factors for PAS; Management of PA | ||||
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