Emergent versus planned delivery in patients with placenta accreta spectrum disorders

Thắng, Nguyễn Mạnh; Anh, Nguyen Thi Huyen; Thanh, Pham Hai; Linh, Pham Thi Thuy; Tran, Cuong

doi:10.1097/md.0000000000028353

Cited by 14 publications

(20 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1,3 Patients with PAS require hysterectomy and a longer hospital stay. 4 Today the main cause of PAS is uterine scar. This rise may be due to lack of expertise, shortage of time, patients' intolerant attitude, improper foetal assessment, and an over-conscious patient.…”

Section: Introductionmentioning

confidence: 99%

To evaluate rising caesarean section rate and factors contributing to it by using Modified Robson’s Criteria at a tertiary care hospital

Shaikh¹,

Kulsoom²,

Fatima³

et al. 2022

Pak J Med Sci

View full text Add to dashboard Cite

Objectives: To determine the frequency of caesarean section with its indication by grouping according to Modified Robson’s Criteria at JPMC. Methods: This is a retrospective study done from 1st January to 30th June 2018. Records of all Caesarean Section performed during the study period were retrieved from elective and emergency operation theatres. Data was extracted from the emergency and elective Theatres registers. and entered in study proforma. Patients with missing data were contacted via a given phone number on file and data collected. None of the Patients Data was totally missing ,as all entries made were done very carefully .Data was entered in SPSS version 26.0. Group-11 and 12 were added in order to identify the main reason for the increase in caesarean sections. Results: Total number of deliveries in six months were 3400. Our study showed a Caesarean Section rate of 36.5 per all live births. The major group contributing was Group-5 (56%). Foetal distress (Group-12) and Primigravida with Inductions or caesarean section before labour (Group-2) showed nearly the same percentages 13.5% and 14% respectively. Conclusions: Planning of the caesarean section of primigravida should be carefully decided. The role of safe VBAC plays the key role in decreasing Cesarean Section rate. Moreover, foetal distress and caesareans in Primigravida should be evaluated with great accuracy to decrease the caesarean section rate. LIST OF ABBREVIATIONS:CS: Caesarean Section, VBAC: Vaginal Birth After Caesarean, SD: Standard Deviation, χ2: Chi-Square. doi: https://doi.org/10.12669/pjms.38.7.5983 How to cite this:Majid E, Kulsoom S, Fatima S, Zuberi BF. To evaluate rising caesarean section rate and factors contributing to it by using Modified Robson’s Criteria at a tertiary care hospital. Pak J Med Sci. 2022;38(7):---------. doi: https://doi.org/10.12669/pjms.38.7.5983 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

show abstract

Section: Introductionmentioning

confidence: 99%

To evaluate rising caesarean section rate and factors contributing to it by using Modified Robson’s Criteria at a tertiary care hospital

Shaikh¹,

Kulsoom²,

Fatima³

et al. 2022

Pak J Med Sci

View full text Add to dashboard Cite

show abstract

“…Thirteen studies compared the birth weights between the PCD and ECD groups. [16][17][18][19][20][21][22][23][24][25]27,28,33] However, one study [16] reported the medians of birth weight in 3 gestational ranges and therefore could not be pooled. In comparison to the ECD group, the pooled birth weight was significantly higher in the PCD group (SMD: 1.64; 95% CI: 1.00-2.27; P < .001; I 2 = 97%).…”

Section: Neonatal Birth Weightmentioning

confidence: 99%

“…Nine studies reported the means of gestational age at delivery in the PCD and ECD gro ups. [18][19][20][21][22]24,25,27,33] The overall pooled estimate for gestational age was significantly higher in the PCD group compared to the ECD group (SMD: 2.20; 95% CI: 1.25-3.15; P < .001; I 2 = 98%). This finding was also seen in the subgroups of women with PP alone (SMD: 1.29; 95% CI: 1.02-1.56; P < .001; I 2 = 22%) and PAS patients with or without coexistent PP (SMD: 2.51; 95% CI: 1.21-3.81; P < .001; I 2 = 98%) (Fig.…”

Section: Quantitative Analysesmentioning

confidence: 99%

“…A total of 1339 non-duplicate records were identified for screening of the titles and abstracts, from which 26 studies were retrieved for full-text review. Finally, the meta-analysis included 2 prospective, [21,22] twelve retrospective, [17][18][19][20][23][24][25][26][27][28]33] and one combined retrospective and prospective cohort studies, [16] involving 2565 women with prenatally diagnosed abnormal placentation (1483 patients and 1082 patients underwent PCD and ECD, respectively) (Fig. 1).…”

Section: Study Selectionmentioning

confidence: 99%

“…Accumulating data has suggested that ECD is associated with a higher risk of adverse maternal outcomes compared to PCD, including more profound intraoperative blood loss, increased need for blood transfusion and intensive care unit admission, and a longer hospital stay. [17][18][19][20][21][22][23][24][25][26][27][28] Regardless, a recent multicenter study found that less than half of prenatally diagnosed PAS patients (39%) in the United States reached a scheduled delivery within the recommended gestational age. [29] As a result, ECD remains an unavoidable and yet common practice for women with abnormal placentation, and understanding the differences between ECD and PCD is critical for optimizing maternal-fetal care.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of planned versus emergency cesarean delivery on neonatal outcomes in pregnancies complicated by abnormal placentation: A systematic review and meta-analysis

Huang

Yang

2023

Medicine

View full text Add to dashboard Cite

Background: Although planned cesarean delivery (PCD) is the mainstay of management for abnormal placentation, some patients still require emergency cesarean delivery (ECD). We aimed to systematically analyze the impact of various modes of delivery on neonatal outcomes. Methods: This study was complied with the PRISMA guidelines and was registered in the PROSPERO (code: CRD42022379487). A systematic search was conducted on Ovid MEDLINE and Embase, Web of Science, PubMed, and the Cochrane databases. Data extracted included gestational age at delivery, birth weight, the Apgar scores at 1 and 5 minutes, numbers of newborns with low Apgar score (<7) at 5 minutes, the rates of neonatal intensive care unit admission, and the rates of neonatal mortality. Results: Fifteen cohort studies met the inclusion criteria, comprising a total of 2565 women (2567 neonates) who underwent PCD (n = 1483) or ECD (n = 1082) for prenatally diagnosed placenta accreta spectrum (PAS) and/or placenta previa (PP). Compared with the ECD group, neonates in the PCD group had significantly higher gestational ages (standardized mean difference [SMD]: 2.20; 95% confidence interval [CI]: 1.25–3.15; P < .001), birth weights (SMD: 1.64; 95% CI: 1.00–2.27; P < .001), and Apgar scores at 1 minute (SMD: 0.51; 95% CI: 0.29–0.73; P < .001) and 5 minutes (SMD: 0.47; 95% CI: 0.25–0.70; P < .001). Additionally, the PCD group had significantly lower rates of neonatal intensive care unit admission (odds ratio [OR]: 0.21; 95% CI: 0.14–0.29; P < .001), low Apgar score at 5 minutes (OR: 0.27; 95% CI: 0.11–0.69; P = .01), and neonatal mortality (OR: 0.13; 95% CI: 0.05–0.33; P < .001). Conclusion: When pregnancies are complicated by abnormal placentation, PCD is linked to noticeably better neonatal outcomes than emergent delivery.

show abstract

Risk factors for intensive care unit admission after cesarean hysterectomy for placenta accreta spectrum

Munoz,

Cheng,

McCann

et al. 2024

Intl J Gynecology & Obste

View full text Add to dashboard Cite

ObjectivePlacenta accreta spectrum (PAS) is a complex disorder of uterine wall disruption with significant morbidity and mortality, particularly at time of delivery. Both physician and physical hospital resource allocation/utilization remains a challenge in PAS cases including intensive care unit (ICU) beds. The primary objective of the present study was to identify preoperative risk factors for ICU admission and create an ICU admission prediction model for patient counseling and resource utilization decision making in an evidence‐based manner.MethodsThis was a case–control study of 145 patients at our PAS referral center undergoing cesarean hysterectomy for PAS. Final confirmation by histopathology was required for inclusion. Patient disposition after surgery (ICU vs post‐anesthesia care unit) was our primary outcome and pre‐/intra‐/postoperative variables were obtained via electronic medical records with an emphasis on the predictive capabilities of the preoperative variables. Uni‐ and multivariate analysis was performed to identify independent predictive factors for ICU admission.ResultsIn this large cohort of 145 patients who underwent cesarean hysterectomy for PAS, with histopathologic confirmation, 63 (43%) were admitted to the ICU following delivery. These patients were more likely to be delivered at an earlier gestational age (34 vs 35 weeks, P < 0.001), have had >2 episodes of vaginal bleeding and emergent delivery compared to patients admitted to patients with routine recovery care (44% vs 18.3%, P = 0.009). Uni‐ and multivariate logistic regression showed an area under the curve of 0.73 (95% CI: [0.63, 0.81], P < 0.001) for prediction of ICU admission with these three variables. Patients with all three predictors had 100% ICU admission rate.ConclusionResource prediction, utilization and allocation remains a challenge in PAS management. By identifying patients with preoperative risk factors for ICU admission, not only can patients be counseled but this resource can be requested preoperatively for staffing and utilization purposes.

show abstract

Emergent versus planned delivery in patients with placenta accreta spectrum disorders

Cited by 14 publications

References 38 publications

To evaluate rising caesarean section rate and factors contributing to it by using Modified Robson’s Criteria at a tertiary care hospital

To evaluate rising caesarean section rate and factors contributing to it by using Modified Robson’s Criteria at a tertiary care hospital

Impact of planned versus emergency cesarean delivery on neonatal outcomes in pregnancies complicated by abnormal placentation: A systematic review and meta-analysis

Risk factors for intensive care unit admission after cesarean hysterectomy for placenta accreta spectrum

Contact Info

Product

Resources

About