• Medicine · Nov 2023

    Surgical approach could be a major factor in placenta previa outcome: A comparative retrospective study.

    • Ala N Uwais, Anas O Satari, Marleen M Hijazin, Ahmed A Al-Abadleh, and Sahel W Haddadin.
    • Department of Obstetrics and Gynecology, Faculty of Medicine, Mutah University, AL-Karak, Jordan.
    • Medicine (Baltimore). 2023 Nov 24; 102 (47): e36437e36437.

    AbstractPlacenta previa is associated with high morbidity and mortality rates due to major hemorrhage during surgery. Thus, a standard surgical approach with a low risk of morbidity is required. This study aimed to propose surgical steps for placenta previa with scarred uterus. All deliveries at the Al-Karak governmental hospital between January 2019 and January 2022 were retrospectively reviewed. Placenta previa cases were divided into 2 groups according to management. Group A was managed by incising the uterus at the level of the fundus to avoid disrupting the placenta, whereas group B was managed by opening the lower uterine segment and delivering the baby through the placenta after the incision. A total of 26 cases with placenta previa were included in this study. Group A (n = 12) was managed by avoiding the placenta and group B (n = 14) was managed by opening through the placenta. No differences were noted between the 2 groups regarding demographics. Patients who underwent the suggested surgical approach (Group A) had less blood loss (median = 775 cc), whereas Group B (median = 1700 cc) (P = .001) had significantly higher blood loss. The duration of hospital stay was significantly shorter in Group A (median = 2 days) than in Group B (median = 6 days) (P = .000). Incising the upper uterine segment to avoid the placenta may lead to better outcomes in terms of blood loss and its consequences.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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