A comparison of antenatally and intraoperatively diagnosed cases of placenta accreta spectrum

Journal Title: Journal of the Turkish-German Gynecological Association - Year 2020, Vol 21, Issue 2

Abstract

Objective: To assess the effect of antenatal diagnosis of placenta accreta spectrum (PAS) on fetomaternal outcomes. Material and Methods: This was a retrospective cohort study conducted from January 2017 to December 2018. Women with PAS diagnosed antenatally were designated as group A and those where diagnosis was suspected during operation and confirmed on histopathology (PAS diagnosed perioperatively) were designated as group B. Outcome in terms of uterine conservation, maternal death, admission of mother to intensive care unit (ICU), perinatal death and neonatal ICU (NICU) admission were recorded. Results: During the study, PAS was confirmed in 96 cases which were included. Out of these, 34 (35.4%) cases were included in group A while 62 (64.6%) were diagnosed intraoperatively (group B). The median number of units of blood transfused was lower in group A compared to group B (4 vs 6, p<0.001). The uterus was conserved more often in group A compared with group B (67.6% vs 43.5%, p=0.024) while admission to ICU occurred significantly more often in group B (26.5% vs 59.7%, p=0.002). Maternal death (p=0.038) and perinatal death (p=0.008) were also significantly higher in group B. More neonates delivered to mothers in group B were admitted to NICU (85.7% vs 24%, p=0.033). Survival analysis showed a statistically significant increase in uterine conservation rate in group A compared with group B (log rank, p=0.04). Conclusion: PAS diagnosed antenatally has better fetomaternal outcome than intraoperative detection of PAS. Diagnosing PAS antenatally is therefore crucial to improve management and achieve a better outcome.

Authors and Affiliations

Rahila Imtiaz, Zubaida Masood, Samia Husain, Sonia Husain, Rubina Izhar, Saba Hussain

Keywords

Related Articles

The relationship between stress during pregnancy with leptin and cortisol blood concentrations and complications of pregnancy in the mother

Objective: Pregnancy is one of the most stressful periods a woman experiences in her life. The present study was an attempt to determine the relationship between maternal stress during pregnancy and cortisol plus materna...

Analysis of cystic hygroma diagnosed in the first trimester: Single-center experience

Objective: To evaluate the obstetric outcomes of fetuses with cystic hygroma other than karyotype abnormalities and structural malformations. Material and Methods: We conducted a retrospective study based on the review...

Why and how to proceed to an ultrasound-guided transvaginal drainage of tubo-ovarian abscesses (with demonstrative video)?

The treatment of the acute phase of complicated tubo-ovarian abscesses relies on antibiotics associated with surgical management in case of visible abscess, poor clinical tolerance and resistance to medical treatment. Tr...

Fetal cardiac tumors: prenatal diagnosis, management and prognosis in 18 cases

Objective: To evaluate the long-term follow-up of patients with fetal cardiac tumors (FCTs), and to review the literature regarding advances in diagnosis and management of FCTs in the last decade. Material and Methods:...

Factors affecting parametrial involvement in cervical cancer patients with tumor size ≤4 cm and selection of low-risk patient group

Objective: The primary aim of this study was to evaluate the factors affecting parametrial involvement in cervical cancer patients with tumor size ≤4 cm and selection of the low-risk patient group based on long-term onco...

Download PDF file
  • EP ID EP685450
  • DOI 10.4274/jtgga.galenos.2019.2019.0063
  • Views 169
  • Downloads 0

How To Cite

Rahila Imtiaz, Zubaida Masood, Samia Husain, Sonia Husain, Rubina Izhar, Saba Hussain (2020). A comparison of antenatally and intraoperatively diagnosed cases of placenta accreta spectrum. Journal of the Turkish-German Gynecological Association, 21(2), -. https://europub.co.uk./articles/-A-685450