NATIONAL HARBOR, MARYLAND– Rates of maternal morbidity in people with placenta accreta were comparable with alternative methods to cesarean hysterectomy no matter the intensity of the condition, based upon information from 60 people.
Presently, the suggested management technique for placenta accreta spectrum (PAS) is a cesarean hysterectomy, however information are doing not have on alternative methods, particularly for people wanting to keep their uterus and possibly protect fertility, Farah H. Amro, MD, of the University of Texas Health Science Center at Houston McGovern Medical School stated in a discussion at the Pregnancy Meeting (abstract 70).
Alternative choices are being studied worldwide, consisting of postponed hysterectomy (generally carried out at 4-6 weeks postpartum), Dr. Amro stated at the conference, which was sponsored by the Society for Maternal-Fetal Medicine.
At UT Houston, postponed hysterectomy is carried out for more aggressive PAS that includes parametrial intrusion, and the placenta left in situ till resorption/passage for those wanting to keep their uterus, Dr. Amro stated in an interview.
In a friend research study at UT Houston, a level IV scholastic center, Dr. Amro and coworkers examined results in 60 people with thought PAS who were offered 3 management alternatives after comprehensive therapy. Of these, 29 chose a cesarean hysterectomy (CH); 16 went with postponed interval hysterectomy (IH) carried out 4-6 weeks after shipment; and 15 people with a choice for uterine conservation were appointed to conservative management.
The research study happened in between January 2020 and July 2023. The main result was composite maternal morbidity, which was additional divided into composite intense morbidity (within 24 hours from cesarean shipment or hysterectomy) and composite postponed morbidity (24 hours or more postoperatively). Secondary results consisted of overall approximated blood loss, require for blood transfusion, unexpected health center readmission, and pathology medical diagnosis.
Total maternal morbidity rates were 55%, 56%, and 53% in the CH, IH, and CM groups, respectively, although those who were prepared for IH and CM had more extreme PAS.
The prepared treatment was carried out in 90% of the CH clients. Around 20% of clients in the IH and CM groups went through unintended treatments. No cases of sepsis or maternal death happened, and uterine infection rates were 0%, 6%, and 13% in the CH, IH, and CM groups, respectively.
Clients in the CM and IH groups were considerably less most likely to need blood transfusions than those in the CH group. In addition, composite postponed morbidity (24 hours or more after surgical treatment) was comparable amongst the groups, with rates of 31%, 38%, and 33% for CH, IH, and CM, respectively (P =.94). These outcomes are very important, provided the issues concerning leaving a placenta in situ after cesarean shipment, stated Dr. Amro.
The findings were restricted by numerous aspects consisting of using information from a single website, the absence of randomization, client compliance, and expense efficiency. The outcomes were reinforced by the varied population and contrast of unique methods that aren't regularly made use of In the United States,
