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393803

Clinical and ultrasonographic predictors of maternal morbidities in patients with placenta accreta spectrum

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Last updated: 23 Dec 2024

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Abstract

Background : The incidence of placenta accreta has been markedly increased. Patients with this condition are exposed to many complications, including massive blood loss, hysterectomy and postpartum haemorrhage.     
Aim : To predict maternal morbidities related to  placenta accreta spectrum (PAS) using clinical and ultrasonographic criteria so proper preoperative preparation and counselling can be done.   
Patients and methods: This study analysed 106 patients diagnosed by ultrasonography as having PAS and confirmed intraoperatively according to FIGO criteria. Planned caesarean sections were done, and the amount of blood loss was calculated. Patients were considered to have massive bleeding if the estimated blood loss was 2500 cc or more.The patients with hysterectomy, bladder injury, and postpartum haemorrhage were identified, and the association with clinical and sonographic signs were analyzed.      
Results: In our study, some ultrasonographic signs such as placenta previa complete centralis, lacunae grading and bridging vessels were associated with massive intraoperative bleeding with Odds ratio 1.47 95% CI (1.35-1.75) (p=0.014) for lacunae grade 2 and 1.26 95% CI (1.07-1.61) (p=0.048) for bridging vessels. However, none of them was an independent predictor for massive intraoperative blood loss in regression analysis. The risk of hysterectomy was increased in patients with lacunae grade 3 (p <0.001), while the risk for bladder injury was significantly increased with bridging vessels 
( p=0.048). None of the clinical characteristics have a relation to maternal morbidities.  
Conclusion: None of the patient,s clinical characteristics statistically linked to maternal morbidities. The ultrasonographic signs of PAS could allow the prediction of maternal complications. 

DOI

10.21608/egyfs.2024.393803

Keywords

Key words: placenta accreta, Intraoperative bleeding, Hysterectomy, ultrasound color Doppler. 

Authors

First Name

Amani

Last Name

Abdelmoety

MiddleName

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Affiliation

Resident of Obstetrics and Gynecology, ministry of health and population, Egypt

Email

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City

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Orcid

-

First Name

Yaser

Last Name

Mosbah

MiddleName

-

Affiliation

Departement of Obstetrics and Gynecology, Mansoura faculty of medicine, Mansoura university, Egypt

Email

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City

-

Orcid

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First Name

Maher

Last Name

Elesawy

MiddleName

-

Affiliation

Departement of Obstetrics and Gynecology, Mansoura faculty of medicine, Mansoura university, Egypt

Email

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City

-

Orcid

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First Name

Mahmoud

Last Name

Mahmoud Thabet

MiddleName

Mohamed Abdelrazik ,

Affiliation

Assistant professor of Obstetrics and Gynecology, Mansoura Faculty of medicine, Mansoura university, Egypt, Departement of Obstetrics and Gynecology, Mansoura faculty of medicine, Mansoura university, Egypt

Email

dr_mahmoudhosam@yahoo.com

City

-

Orcid

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Volume

28

Article Issue

6

Related Issue

51754

Issue Date

2024-11-01

Receive Date

2024-11-26

Publish Date

2024-11-01

Page Start

129

Page End

137

Print ISSN

1110-6352

Online ISSN

2536-9768

Link

https://egyfs.journals.ekb.eg/article_393803.html

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https://egyfs.journals.ekb.eg/service?article_code=393803

Order

393,803

Type

Original Article

Type Code

319

Publication Type

Journal

Publication Title

The Egyptian Journal of Fertility of Sterility

Publication Link

https://egyfs.journals.ekb.eg/

MainTitle

Clinical and ultrasonographic predictors of maternal morbidities in patients with placenta accreta spectrum

Details

Type

Article

Created At

23 Dec 2024