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Local uterine resection with Bakri balloon placement in placenta accreta spectrum disorders

OBJECTIVE: Placenta accreta spectrum (PAS) is a potentially life-threatening condition characterized by the abnormal adherence of the placenta to the implantation site. We sought to evaluate the efficacy, surgical feasibility, risks, and advantages of local uterine resection in cases complicated wit...

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Autor principal: Üstünyurt, Emin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Galenos Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7406901/
https://www.ncbi.nlm.nih.gov/pubmed/32850185
http://dx.doi.org/10.4274/tjod.galenos.2020.82652
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author Üstünyurt, Emin
author_facet Üstünyurt, Emin
author_sort Üstünyurt, Emin
collection PubMed
description OBJECTIVE: Placenta accreta spectrum (PAS) is a potentially life-threatening condition characterized by the abnormal adherence of the placenta to the implantation site. We sought to evaluate the efficacy, surgical feasibility, risks, and advantages of local uterine resection in cases complicated with PAS. MATERIALS AND METHODS: This study included 97 patients with PAS, which was confirmed during surgery and by histopathological examination between January 2013 and December 2019. The patients were divided into two groups based on operative approach. The study population (local resection group) consisted of 30 cases in whom total resection of adherent placenta and myometrium was performed, whereas the control group (hysterectomy group) of 67 cesarean hysterectomy cases. RESULTS: Patients who underwent hysterectomy had significantly more bleeding than the local resection group (1180±160 mL vs 877±484 mL; p=0.002). The mean number of transfused packed red blood cells (pRBCs) was greater in the hysterectomy group (4.5±2.3) than in the local resection group (2.6±3.1; p=0.001). Transfusion rate of four and/or more pRBCs was 67.2% in the hysterectomy group and 33.3% in the local resection group, which indicated a statistically significant difference (p=0.002). Of patients, 29.6% required intensive care unit in the hysterectomy group and 6.7% in the local resection group (p=0.023). CONCLUSION: Local resection can be performed safely in selected PAS cases. In these cases, using a standardized protocol in terms of patient selection and surgical procedure will reduce morbidity and mortality.
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spelling pubmed-74069012020-08-25 Local uterine resection with Bakri balloon placement in placenta accreta spectrum disorders Üstünyurt, Emin Turk J Obstet Gynecol Clinical Investigation OBJECTIVE: Placenta accreta spectrum (PAS) is a potentially life-threatening condition characterized by the abnormal adherence of the placenta to the implantation site. We sought to evaluate the efficacy, surgical feasibility, risks, and advantages of local uterine resection in cases complicated with PAS. MATERIALS AND METHODS: This study included 97 patients with PAS, which was confirmed during surgery and by histopathological examination between January 2013 and December 2019. The patients were divided into two groups based on operative approach. The study population (local resection group) consisted of 30 cases in whom total resection of adherent placenta and myometrium was performed, whereas the control group (hysterectomy group) of 67 cesarean hysterectomy cases. RESULTS: Patients who underwent hysterectomy had significantly more bleeding than the local resection group (1180±160 mL vs 877±484 mL; p=0.002). The mean number of transfused packed red blood cells (pRBCs) was greater in the hysterectomy group (4.5±2.3) than in the local resection group (2.6±3.1; p=0.001). Transfusion rate of four and/or more pRBCs was 67.2% in the hysterectomy group and 33.3% in the local resection group, which indicated a statistically significant difference (p=0.002). Of patients, 29.6% required intensive care unit in the hysterectomy group and 6.7% in the local resection group (p=0.023). CONCLUSION: Local resection can be performed safely in selected PAS cases. In these cases, using a standardized protocol in terms of patient selection and surgical procedure will reduce morbidity and mortality. Galenos Publishing 2020-06 2020-07-29 /pmc/articles/PMC7406901/ /pubmed/32850185 http://dx.doi.org/10.4274/tjod.galenos.2020.82652 Text en ©Copyright 2020 by Turkish Society of Obstetrics and Gynecology | Turkish Journal of Obstetrics and Gynecology published by Galenos Publishing House. http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Investigation
Üstünyurt, Emin
Local uterine resection with Bakri balloon placement in placenta accreta spectrum disorders
title Local uterine resection with Bakri balloon placement in placenta accreta spectrum disorders
title_full Local uterine resection with Bakri balloon placement in placenta accreta spectrum disorders
title_fullStr Local uterine resection with Bakri balloon placement in placenta accreta spectrum disorders
title_full_unstemmed Local uterine resection with Bakri balloon placement in placenta accreta spectrum disorders
title_short Local uterine resection with Bakri balloon placement in placenta accreta spectrum disorders
title_sort local uterine resection with bakri balloon placement in placenta accreta spectrum disorders
topic Clinical Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7406901/
https://www.ncbi.nlm.nih.gov/pubmed/32850185
http://dx.doi.org/10.4274/tjod.galenos.2020.82652
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