Surgical approach could be a major factor in placenta previa outcome: A comparative retrospective study
Placenta previa is associated with high morbidity and mortality rates due to major hemorrhage during surgery. Thus, a standard surgical approach with a low risk of morbidity is required. This study aimed to propose surgical steps for placenta previa with scarred uterus. All deliveries at the Al-Kara...
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Veröffentlicht in: | Medicine (Baltimore) 2023-11, Vol.102 (47), p.e36437-e36437 |
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Format: | Artikel |
Sprache: | eng |
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Zusammenfassung: | Placenta previa is associated with high morbidity and mortality rates due to major hemorrhage during surgery. Thus, a standard surgical approach with a low risk of morbidity is required. This study aimed to propose surgical steps for placenta previa with scarred uterus. All deliveries at the Al-Karak governmental hospital between January 2019 and January 2022 were retrospectively reviewed. Placenta previa cases were divided into 2 groups according to management. Group A was managed by incising the uterus at the level of the fundus to avoid disrupting the placenta, whereas group B was managed by opening the lower uterine segment and delivering the baby through the placenta after the incision. A total of 26 cases with placenta previa were included in this study. Group A (n = 12) was managed by avoiding the placenta and group B (n = 14) was managed by opening through the placenta. No differences were noted between the 2 groups regarding demographics. Patients who underwent the suggested surgical approach (Group A) had less blood loss (median = 775 cc), whereas Group B (median = 1700 cc) ( P = .001) had significantly higher blood loss. The duration of hospital stay was significantly shorter in Group A (median = 2 days) than in Group B (median = 6 days) ( P = .000). Incising the upper uterine segment to avoid the placenta may lead to better outcomes in terms of blood loss and its consequences. |
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ISSN: | 0025-7974 1536-5964 |
DOI: | 10.1097/MD.0000000000036437 |