Expected Versus Unexpected Delivery for Placenta Accreta Spectrum
                    (PAS) Disorders with Same Team in Single Tertiary Center

Hakan Golbasi; Burak Bayraktar; Ceren Golbasi; Ibrahim Omeroglu; Baris Sever; Duygu Adiyaman; Seyda Kayhan Omeroglu; Atalay Ekin; Mehmet Özeren

doi:10.1055/a-1915-5832

Zeitschrift für Geburtshilfe und Neonatologie, Table of Contents

Z Geburtshilfe Neonatol 2022; 226(06): 391-398
DOI: 10.1055/a-1915-5832

Original Article

Expected Versus Unexpected Delivery for Placenta Accreta Spectrum (PAS) Disorders with Same Team in Single Tertiary Center

Hakan Golbasi

¹University of Health Sciences Tepecik Training and Research Hospital, Department of Perinatology, Izmir, Turkey

,

Burak Bayraktar

²University of Health Sciences Tepecik Training and Research Hospital, Department of Obstetrics and Gynecology, Izmir, Turkey

,

Ceren Golbasi

³Tinaztepe University Faculty of Health Sciences, Department of Obstetrics and Gynecology, Izmir, Turkey

,

Ibrahim Omeroglu

¹University of Health Sciences Tepecik Training and Research Hospital, Department of Perinatology, Izmir, Turkey

,

Baris Sever

¹University of Health Sciences Tepecik Training and Research Hospital, Department of Perinatology, Izmir, Turkey

,

Duygu Adiyaman

¹University of Health Sciences Tepecik Training and Research Hospital, Department of Perinatology, Izmir, Turkey

,

Seyda Kayhan Omeroglu

⁴University of Health Sciences Suat Seren Chest Diseases and Surgery Training and Research Hospital, Department of Anesthesia and Reanimation, Izmir, Turkey

,

Atalay Ekin

¹University of Health Sciences Tepecik Training and Research Hospital, Department of Perinatology, Izmir, Turkey

,

Mehmet Özeren

¹University of Health Sciences Tepecik Training and Research Hospital, Department of Perinatology, Izmir, Turkey

› Author Affiliations

Abstract

Objectives To evaluate the maternal and neonatal outcomes of expected and unexpected pathologically proven placenta accreta spectrum (PAS) cases in a single multidisciplinary center.

Material and Methods This was a retrospective cohort study of 92 PAS cases from January 2011 until September 2021. Only cases with histopathologically invasive placentation were included in the study. The cases diagnosed at the time of delivery were defined as unexpected PAS (uPAS) and those diagnosed antenatally as expected PAS (ePAS). Maternal and neonatal outcomes of both groups were compared.

Results Thirty-five (38%) of 92 cases were in the uPAS group. Placenta previa and high-grade PAS (percreata) were significantly higher in the ePAS group (p=0.028, p<0.001; respectively). The mean packed red blood cell transfusion was significantly higher in the uPAS group (p=0.030) but transfusions of other blood products were similar in the two groups. There was no significant difference in intraoperative complication rates between the two groups. Preterm delivery (<37 weeks) was significantly higher in the ePAS group (p<0.001), but there was no significant difference between the two groups in terms of adverse neonatal outcomes.

Conclusions Our single center data show that although ePAS cases include more highly invasive PAS cases, maternal hemorrhagic morbidity is lower than uPAS cases. Reducing maternal morbidity in PAS cases can be achieved by increasing antenatal diagnosis.

Key words

placenta accreta spectrum - placenta percreta - multidisciplinary management - prenatal diagnosis

Full Text

References

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