Two-sided TAP block with 0.25% bupivacaine in parturients who undergo cesarean section with a Pfannenstiel incision under general anesthesia can decrease postoperative pain and analgesic consumption. The time to the first analgesic rescue was longer in the parturients who received the TAP block.

Background: Placenta accreta spectrum (PAS) is a major cause of obstetric bleeding in third trimester of pregnancy. Objective: This study aimed to compare the outcomes of uterine preservation surgery vs. hysterectomy in women with PAS. Materials and Methods: In this retrospective cross-sectional study, the records of 68 women with PAS referred to the Imam Khomeini hospital in Ahvaz, Iran, between March 2015 and February 2020 were included. The women were divided into 2 groups according to surgical approach: hysterectomy vs. uterine preservation (including just removing the lower segment, removing the lower segment with uterine artery ligation, or removing the lower segment with hypogastric artery ligation during cesarean section). The need for blood components transfusion (whole blood, packed cells, and fresh frozen plasma), maternal mortality, duration of surgery, and length of hospitalization were compared between groups. Results: In total, we investigated 68 women between the ages of 24-45 yr (mean age of 32.88 ± 5.08 yr). All participants were multiparous and underwent cesarean section. Furthermore, 28 women (41.2%) had a history of curettage. In total, 24 women (35.3%) underwent a hysterectomy, and 44 (64.7%) underwent uterine preservative surgeries. There were no significant differences between groups of hysterectomy and uterinepreservative surgeries in terms of the need for blood components transfusion, maternal mortality, duration of surgery, and length of hospitalization. Conclusion: The results of this study showed no significant difference between groups regarding the studied outcomes. Therefore, conservative surgeries could be used to preserve the uterus instead of hysterectomy in women with PAS. Key words: Placenta accreta, Placenta diseases, Pregnancy complications,Conservative treatment, Hysterectomy.

Objective: To evaluate the success rate of laparoscopy and hysteroscopic Dilation & Curettage in treating cesarean scar pregnancy. Methods: This cross-sectional study was carried on patients suspicious to CSP referred to Imam Khomeini Hospital, Ahvaz from Jun 2016 to March 2018. Gestational site was carefully evaluated by hysteroscopy and then curettage was carried out under laparoscopic guidance. The primary outcome in the study was time interval from treatment to hCG resolution. Moreover, the secondary outcomes were vaginal bleeding time and residual mass size. Results: In this study, 30 women with intrauterine CSP were evaluated. Of these, 5 had live embryos and 25 had dead fetuses. The success rate of treatment was 100%. Only one patient needed to transfusion. The mean and median duration of Bhcg resolution were 30.9 and 28 days, respectively. Moreover, The mean and median duration of vaginal bleeding were 30.9 and 28 days, respectively. The mean level of residual mass was 9.8 mm3 (ranged from 1 to 25 mm3). Conclusion: Overall, the findings of this study showed that D&C effectively treated CSP patients (100% success rate), reduced the time of Bhcg resolution and also reduced vaginal bleeding time.