Morbidly adherent placenta and cesarean section methods. A retrospective comparative multicentric study on two different skin and uterine incision

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dc.authoridTinelli, Andrea/0000-0001-8426-8490
dc.authorwosidTinelli, Andrea/B-6811-2014
dc.contributor.authorSoyer-Caliskan, Canan
dc.contributor.authorCelik, Samettin
dc.contributor.authorBasbug, Alper
dc.contributor.authorHatirnaz, Safak
dc.contributor.authorGuclu, Mehmet
dc.contributor.authorAkbaba, Eren
dc.contributor.authorTinelli, Andrea
dc.date.accessioned2021-12-01T18:51:07Z
dc.date.available2021-12-01T18:51:07Z
dc.date.issued2021
dc.department[Belirlenecek]en_US
dc.description.abstractObjectives: Morbidly adherent placenta (MAP) is one of leading causes of maternal mortality, with an increasing rate because of repeated cesarean sections (CS). The primary objective of this study is to compare two techniques of skin and uterine incisions in patients with MAP, evaluating the maternal fetal impact of the two methods. Retrospective multicentric cohort study. Material and methods: A total of 116 women with MAP diagnosis were enrolled and divided in two groups. Group one, comprised of 81 patients, abdominal entry was performed by Pfannenstiel skin incision plus an upper transverse lower uterine segment (LUS) incision (transverse-transverse), which was 2-3 cm above the MAP border, with the uterus in the abdomen. In group two, comprised of 35 patients, abdominal entry was performed by an infra-umbilical midline abdominal incision, by vertical-vertical technique, and the pregnant uterus was incised by a midline incision (vertical) from the fundus till the border of the MAP. Total surgery time, blood loss, blood product consumption, total hospital stay, cosmetic outcomes, and postoperative complications were investigated. Results: Total time of surgery was significantly shorter in group 1 (p < 0.05). Intraoperative blood loss was higher in group 2. Difference between preoperative and postoperative Hb and Htc levels were 3.30 +/- 1.04 and 12.99 +/- 5.07 respectively (p = 0.012; p = 0.033). The use of erythrocyte suspension (ES), fresh frozen plasma (FFP), and cryoprecipitate and thrombocyte suspension (TS) were found to be significantly lower in patients of group 1than vertical-vertical group (p = 0.008, p = 0.009, p = 0.001, p = 0.001, respectively). There was no difference in terms of total length of hospital stay between groups. Conclusions: In a subgroup of patients diagnosed for MAP, the transverse-transverse incision resulted in less bleeding, less blood and blood product use, and had better cosmetic results than vertical-vertical incision. Moreover, the total time of surgery, crucial for MAP patients, seems to be shorter also in transverse-transverse incision than in vertical-vertical incision.en_US
dc.identifier.doi10.5603/GP.a2020.0192
dc.identifier.endpage364en_US
dc.identifier.issn0017-0011
dc.identifier.issn2543-6767
dc.identifier.issue5en_US
dc.identifier.pmid33844256en_US
dc.identifier.scopus2-s2.0-85105788658en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage359en_US
dc.identifier.urihttps://doi.org/10.5603/GP.a2020.0192
dc.identifier.urihttps://hdl.handle.net/20.500.12684/10970
dc.identifier.volume92en_US
dc.identifier.wosWOS:000661442400005en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherVia Medicaen_US
dc.relation.ispartofGinekologia Polskaen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectmorbidly adherent placentaen_US
dc.subjectpfannenstiel incisionen_US
dc.subjectuterine incisionen_US
dc.subjectcesarean sectionen_US
dc.subjectcomplicationsen_US
dc.subjectDiagnosisen_US
dc.subjectAccretaen_US
dc.subjectManagementen_US
dc.subjectSpectrumen_US
dc.subjectPreviaen_US
dc.titleMorbidly adherent placenta and cesarean section methods. A retrospective comparative multicentric study on two different skin and uterine incisionen_US
dc.typeArticleen_US

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