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- Title
Efficacy and safety of management of placenta accreta spectrum by transverse uterine fundal incision in a single tertiary care centre: A retrospective study.
- Authors
ROY, KALLOL KUMAR; ZANGMO, RINCHEN; DAS, ANAMIKA; SURESH, GAYATRI; RAI, RAKHI; GIRISH, BHAVANA; KUMARI, ARCHANA; P., VANAMAIL; BHARTI, JUHI; SINGHAL, SEEMA; MEENA, JYOTI
- Abstract
Background. We assessed the efficacy and safety of management of morbidly adherent placenta by the transfundal uterine incision approach. As a secondary outcome measure, we compared ultrasound and magnetic resonance imaging (MRI) for the diagnosis of adherent placenta. Methods. We retrospectively analysed the records of 5 years of women with adherent placenta. Twenty-five women with an antenatal diagnosis of placenta increta and percreta operated by transfundal uterine incision were included. Blood loss, transfusion requirements, operative injuries, and maternal and neonatal intensive care unit (ICU) stay were compared among three different types of adherent placenta. Surgical and other outcome measures were also analysed. Results. On antenatal screening with ultrasound, an accurate diagnosis could be achieved in all cases of increta and two-thirds of percreta. Antenatal diagnosis by MRI detected 93.3% of increta and all percreta cases. The mean (SD) gestation at delivery was 34 (4.9) weeks in accreta, 34.9 (2.7) weeks in increta and 31 (4.8) weeks in percreta patients. The mean blood loss encountered intraoperatively was 1012.5 (193.1) ml, 1566.67 (566.52) ml and 1591.67 (629.61) ml in accreta, increta and percreta patients, respectively. Inadvertent bladder injury occurred in 3 women who had placenta percreta invading the bladder. There was no long-term morbidity and no mortality. Conclusion. Transfundal incision for delivery of baby is associated with the advantage of avoiding the placenta thereby minimizing blood loss.
- Subjects
PLACENTA praevia; PLACENTA accreta; NEONATAL intensive care units; MAGNETIC resonance imaging; TERTIARY care; PRENATAL diagnosis
- Publication
National Medical Journal of India, 2024, Vol 37, Issue 1, p9
- ISSN
0970-258X
- Publication type
Article
- DOI
10.25259/NMJI_331_21