Zhengping Liu1,2, Dazhi Fan1,2, Dongxin Lin1, Huishan Zhang1, Jiaming Rao1, Wen Wang2, Shuzhen Wu2, Yan Liu2, Xiaoling Guo1,2. 1. Foshan Fetal Medicine Research Institute, Affiliated Foshan Women and Children Hospital, Southern Medical University Foshan 528000, Guangdong, China. 2. Department of Obstetrics, Affiliated Foshan Women and Children Hospital, Southern Medical University Foshan 528000, Guangdong, China.
Abstract
OBJECTIVE: To compare the effectiveness of a new double-uterine-incision, based on Ar's incision, with single-uterine-incision during cesarean section in pregnancy concurrently complicated by placenta previa and placenta accreta spectrum. METHODS: A retrospective cohort study including 260 participants was conducted between January 2014 and June 2019. The participants only underwent Ar's incision in the single-uterine-incision group and participants underwent two uterine incisions in the new double-uterine-incision group. The demographic and clinical characteristics were compared between the two groups. RESULTS: Fifty-six participants (21.5%) underwent a double-incision, and the other 204 underwent a single-incision. The incidence of previous cesarean delivery (91.1% vs. 68.6%) and anterior placenta (76.8% vs. 53.4%) was higher in the double-incision group. The blood loss (3400 ml vs. 1600 ml) and the need for blood transfusion (100.0% vs. 82.8%) were higher in the double-incision group. There was no significant difference between the two groups (one (1.8%) in the double-incision group and 10 (4.9%) in the single-incision group) in need for subtotal hysterectomy. After adjusting for confounding factors, there was no significant difference between the two groups concerning blood loss, blood transfusion, maternal ICU, or length of hospital stay; and the incidence of subtotal hysterectomy was lower in the double-incision group. CONCLUSION: This new double-uterine-incision, based on Ar's incision, is an effective and valuable procedure for pregnant women with placenta previa complicated by placenta accreta spectrum, especially in women with a serious condition. It is an option for pregnant women concurrently complicated by placenta previa and placenta accreta spectrum who desire future fertility. AJTR
OBJECTIVE: To compare the effectiveness of a new double-uterine-incision, based on Ar's incision, with single-uterine-incision during cesarean section in pregnancy concurrently complicated by placenta previa and placenta accreta spectrum. METHODS: A retrospective cohort study including 260 participants was conducted between January 2014 and June 2019. The participants only underwent Ar's incision in the single-uterine-incision group and participants underwent two uterine incisions in the new double-uterine-incision group. The demographic and clinical characteristics were compared between the two groups. RESULTS: Fifty-six participants (21.5%) underwent a double-incision, and the other 204 underwent a single-incision. The incidence of previous cesarean delivery (91.1% vs. 68.6%) and anterior placenta (76.8% vs. 53.4%) was higher in the double-incision group. The blood loss (3400 ml vs. 1600 ml) and the need for blood transfusion (100.0% vs. 82.8%) were higher in the double-incision group. There was no significant difference between the two groups (one (1.8%) in the double-incision group and 10 (4.9%) in the single-incision group) in need for subtotal hysterectomy. After adjusting for confounding factors, there was no significant difference between the two groups concerning blood loss, blood transfusion, maternal ICU, or length of hospital stay; and the incidence of subtotal hysterectomy was lower in the double-incision group. CONCLUSION: This new double-uterine-incision, based on Ar's incision, is an effective and valuable procedure for pregnant women with placenta previa complicated by placenta accreta spectrum, especially in women with a serious condition. It is an option for pregnant women concurrently complicated by placenta previa and placenta accreta spectrum who desire future fertility. AJTR
Authors: José M Palacios Jaraquemada; Mario Pesaresi; Juan C Nassif; Susana Hermosid Journal: Acta Obstet Gynecol Scand Date: 2004-08 Impact factor: 3.636