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Interval Placental Delivery: A New Approach to Deal with Placenta Accreta Spectrum (PAS) Disorders: A Cohort Study

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Last updated: 24 Dec 2024

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Abstract

Background: Placenta accreta spectrum (PAS) disorders are one of the most terrible conditions in obstetrics. The major complication associated with PAS disorders is massive hemorrhage, which ultimately may lead to maternal death. Objectives: This study aimed to detect the optimum time and mode of interventions to remove the morbidly adherent placenta after leaving it in situ for conservative management. Patients and Methods: This was a cohort study carried out at the Obstetrics and Gynecology Department, Minia Maternity and Children University Hospital through the period from March 2018 to December 2020. The total number of patients with a placenta that was left in place was 20 patients out of 29 patients who were eligible for the study. Results: This approach of leaving the placenta in place then interval placental delivery was successful in 16 cases (80%). Four cases needed hysterectomy. Placental removal was through spontaneous placental resorption in one case (5%), a spontaneous expulsion of the placenta in one case (5%), in addition to a successful interval placental delivery through D & C in 2 cases (10%) as well as removal by mini-laparotomy in 12 cases (60%). The mean time between the cesarean section and the 2nd set of interventions to remove the placenta was 48.2 ± 6.7 days. Conclusion: Conservative treatment by leaving the placenta in place followed by interval placental delivery seemed to be an appropriate management choice in selected patients desiring preservation of the uterus, but complications such as sepsis and secondary postpartum hemorrhage should be carefully diagnosed and appropriately managed.  

DOI

10.21608/ejhm.2022.277500

Keywords

Interval placental delivery, PAS disorders, Minia University

Authors

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Nashwa M.

Last Name

Adel

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First Name

Mahmoud H.

Last Name

Ibrahim

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First Name

Ahmed R.

Last Name

Abdelraheim

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First Name

Saad

Last Name

El Gelany

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First Name

Ayman M.

Last Name

Yousef

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First Name

Ahmed K.

Last Name

Abdelhakium

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First Name

Ahmed A.

Last Name

Ghaney

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First Name

Mohamed A.

Last Name

Amin

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Email

mohamed.ameen@mu.edu.eg

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Volume

89

Article Issue

2

Related Issue

37472

Issue Date

2022-10-01

Receive Date

2022-12-31

Publish Date

2022-10-01

Page Start

8,004

Page End

8,009

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_277500.html

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https://ejhm.journals.ekb.eg/service?article_code=277500

Order

284

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Interval Placental Delivery: A New Approach to Deal with Placenta Accreta Spectrum (PAS) Disorders: A Cohort Study

Details

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Article

Created At

22 Jan 2023