Catherine Lu MD , Carol Schneider MD , Caroline Corbett MD , Anet Maksymowicz MD , Devon Evans MD
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引用次数: 0
Abstract
Objectives
The placenta accreta spectrum disorders (PASD) are associated with significant maternal and neonatal morbidity and mortality worldwide. As cesarean delivery rates increase, so does the rate of PASD. PASD antepartum diagnosis and perioperative management are evolving, and we primarily aimed to share our tertiary care centre’s institutional approach and outcomes over a decade.
Methods
A retrospective medical record review of cesarean hysterectomy for suspected or confirmed PASD was conducted at a single tertiary centre in Canada from 2010 to 2021.
Results
A total of 46 records remained after applying the exclusion criteria, with a diagnosis of PASD in 94% of cases, and 20% consistent with accreta, 48% with increta, and 26% with percreta. Cesarean hysterectomies were conducted on an unscheduled emergency basis in 41% of cases. All cases had antenatal ultrasound imaging, and 57% received an antenatal MRI. Prophylactic ureteric stenting occurred in 37% of cases. Mean total operative time was 97 minutes, and 50% of cases received an intraoperative blood transfusion. Ureteric injury occurred in 2% of cases, and admission to the intensive care unit in 13% of cases.
Conclusions
PASD is a complex and highly morbid condition. We have shared our institutional experience and explored some variations in practice, including the use of prophylactic ureteric stenting. Additional research is needed to further explore the optimal methods to diagnose and manage this complex disorder.
期刊介绍:
Journal of Obstetrics and Gynaecology Canada (JOGC) is Canada"s peer-reviewed journal of obstetrics, gynaecology, and women"s health. Each monthly issue contains original research articles, reviews, case reports, commentaries, and editorials on all aspects of reproductive health. JOGC is the original publication source of evidence-based clinical guidelines, committee opinions, and policy statements that derive from standing or ad hoc committees of the Society of Obstetricians and Gynaecologists of Canada. JOGC is included in the National Library of Medicine"s MEDLINE database, and abstracts from JOGC are accessible on PubMed.