Expected Versus Unexpected Delivery for Placenta Accreta Spectrum
                    (PAS) Disorders with Same Team in Single Tertiary Center

Gölbaşı, Hakan; Bayraktar, Burak; Gölbaşı, Ceren; Ömeroğlu, İbrahim; Sever, Barış; Adiyaman, Duygu; Ömeroğlu, Şeyda Kayhan; Ekin, Atalay; Özeren, Mehmet

doi:10.1055/a-1915-5832

Cited by 3 publications

(2 citation statements)

References 42 publications

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“…This may be due to the delivery planning from 35 to 36 WG to reduce the risk of severe hemorrhage. Similar results were found in previous studies [27,28].…”

Section: F O R P U B L I C a T I O Nsupporting

confidence: 93%

The impact of antenatal diagnosis of placenta accreta on reducing blood loss: a 57-case monocentre retrospective study

Jarraya¹,

Kammoun²,

Hadjkacem³

et al. 2024

Ital J Gynaecol Obstet

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Objective. The aim of our study was to investigate the impact of antenatal diagnosis of PA on blood loss, blood transfusions, and maternal and neonatal morbidity and mortality. Materials and Methods. This is a monocenter retrospective study including all patients who had failed manual removal of the placenta or evidence of placental invasion at the surgery. The patients included were divided into 2 groups:-Group 1: patients with an antenatal diagnosis according to the ultrasounds or magnetic resonance imaging data.-Group 2: patients with unexpected placenta accreta.Then, we compared blood loss estimated by Gross formula, transfusions, and maternal and neonatal morbidity in both groups.Results. In our series, 57 cases of PA were included: 35 patients with antenatal diagnosis (group 1) and 22 with unexpected PA (group 2). The bleeding estimation was 1610 ± 908 ml in group 1 versus 2480 ± 1317 ml in group 2, with p = 0.007. The need for transfusion was reduced from 95.4 % to 17 % when PA was diagnosed antenatally with p = 0.001. Unexpected PA was correlated with an increased risk of severe bleeding with OR 2.35; 95%CI 1.08-5.62 and transfusion requirements with OR 1.85; 95%CI: 1.18-6.1. However, expected PA was correlated with a higher risk of prematurity with OR 2.04, 95%CI 1.05-4.8. Conclusions.The antenatal diagnosis of placenta accreta allowed better maternal outcomes by reducing the blood loss and transfusions requirements. However, it increased the incidence of planned preterm birth.

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“…This may be due to the delivery planning from 35 to 36 WG to reduce the risk of severe hemorrhage. Similar results were found in previous studies [27,28].…”

Section: F O R P U B L I C a T I O Nsupporting

confidence: 93%

The impact of antenatal diagnosis of placenta accreta on reducing blood loss: a 57-case monocentre retrospective study

Jarraya¹,

Kammoun²,

Hadjkacem³

et al. 2024

Ital J Gynaecol Obstet

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“…This is consistent with the findings of previous research where a planned delivery for PAS with a multidisciplinary team showed favourable neonatal outcomes when compared with an urgent delivery [ 18 , 20 , 23 , 35 ]. However, it is worth noting that several studies did not find significant differences in neonatal outcomes between the two delivery groups [ 25 , 36 , 37 ]. The most relevant factor influencing neonatal outcomes in women with PAS is gestational age at delivery, with higher gestational ages leading to improved neonatal outcomes [ 18 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

Obstetric and haematological management and outcomes of women with placenta accreta spectrum by planned or urgent delivery: Secondary data analysis of a public referral hospital in Lebanon

McCall,

Mansour,

Khazaal

et al. 2024

PLoS ONE

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Background Lebanon has a high caesarean section use and consequently, placenta accreta spectrum (PAS) is becoming more common. Objectives To compare maternal characteristics, management, and outcomes of women with PAS by planned or urgent delivery at a major public referral hospital in Lebanon. Design Secondary data analysis of prospectively collected data. Setting Rafik Hariri University Hospital (public referral hospital), Beirut, Lebanon. Participants 159 pregnant and postpartum women with confirmed PAS between 2007–2020. Main outcome measures Maternal characteristics, management, and maternal and neonatal outcomes. Results Out of the 159 women with PAS included, 107 (67.3%) underwent planned caesarean delivery and 52 (32.7%) had urgent delivery. Women who underwent urgent delivery for PAS management were more likely to experience antenatal vaginal bleeding compared to those in the planned group (55.8% vs 28.0%, p<0.001). Median gestational age at delivery was significantly lower for the urgent group compared to the planned (34 vs. 36 weeks, p<0.001). There were no significant differences in terms of blood transfusion rates and major maternal morbidity between the two groups; however, median estimated blood loss was significantly higher for women with urgent delivery (1500ml vs. 1200ml, p = 0.011). Furthermore, the urgent delivery group had a significantly lower birth weight (2177.5g vs. 2560g, p<0.001) with higher rates of neonatal intensive care unit (NICU) admission (53.7% vs 23.8%, p<0.001) and perinatal mortality (18.5% vs 3.8%, p = 0.005). Conclusion Urgent delivery among women with PAS is associated with worse maternal and neonatal outcomes compared to the planned approach. Therefore, early referral of women with known or suspected PAS to specialized centres is highly desirable to maximise optimal outcomes for both women and infants.

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Comparison of maternal outcomes and clinical characteristics of prenatally vs nonprenatally diagnosed placenta accreta spectrum: a systematic review and meta-analysis

Sugai,

Yamawaki,

Sekizuka

et al. 2023

American Journal of Obstetrics & Gynecology MFM

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Expected Versus Unexpected Delivery for Placenta Accreta Spectrum (PAS) Disorders with Same Team in Single Tertiary Center

Cited by 3 publications

References 42 publications

The impact of antenatal diagnosis of placenta accreta on reducing blood loss: a 57-case monocentre retrospective study

The impact of antenatal diagnosis of placenta accreta on reducing blood loss: a 57-case monocentre retrospective study

Obstetric and haematological management and outcomes of women with placenta accreta spectrum by planned or urgent delivery: Secondary data analysis of a public referral hospital in Lebanon

Comparison of maternal outcomes and clinical characteristics of prenatally vs nonprenatally diagnosed placenta accreta spectrum: a systematic review and meta-analysis

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