An examination by year of cases applied with caesarean hysterectomy because of placenta percreta in a tertiary centre: a retrospective cohort study
, 2, 2, 3, 4, 2
Abstract
Objectives: To examine cases applied with caesarean hysterectomy because of placenta percreta by comparing changes
in treatment strategies and complications according to year.
Material and methods: A retrospective examination was made of 93 patients applied with caesarean hysterectomy with
a diagnosis of placenta percreta in 5-year periods of 2005–2009, 2010–2014, and 2015–2019. Demographic characteristics
were recorded, and previous caesareans, history of myomectomy and curettage, gestational weeks, and infant birthweight.
Intraoperative and postoperative findings were recorded as operating time, length of stay in hospital and Intensive Care Unit
(ICU), transfusion requirement, the amount of erythrocyte suspension (ES) and fresh frozen plasma (FFP) transfused, and requirement
for massive transfusion. Anaesthesia type, complications, and the preferred skin-uterus incision were also recorded.
Results: The 93 patients comprised 8 cases in the period 2005–2009, 23 in 2010–2014, and 62 in 2015–2019. The number
of previous caesarean procedures was observed to increase in parallel with these case numbers. A significant increase was
observed in the gestational week of birth, and infant birthweight, and a decrease in operating times. In later years there was
seen to be a lower amount of ES and FFP transfused and fewer patients with massive transfusion. Preoperative diagnosis
of placenta percreta, the highest preference for general anaesthesia, selection of midline vertical skin incision and uterine
fundal incision were greatest in the period 2015–2019.
Conclusions: In cases with placenta percreta, of which there is an increasing incidence, maternal and infant outcomes
can be optimised with prenatal diagnosis and planned caesarean hysterectomy by a multidisciplinary team with optimal
prenatal preparation.
Keywords: placenta percretacesarean hysterectomyprenatal diagnosisperinatal outcome
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