Alloush, M., Mohamed, M., Idris, Y., Hussaein, Y. (2021). Evaluation of the Role of Planned Conservative Surgery for Management of Morbidly Adherent Placenta. Benha Journal of Applied Sciences, 6(6), 187-192. doi: 10.21608/bjas.2021.214410
M.K. Alloush; M.I. Mohamed; Y.S.Idris Idris; Y.J. Hussaein. "Evaluation of the Role of Planned Conservative Surgery for Management of Morbidly Adherent Placenta". Benha Journal of Applied Sciences, 6, 6, 2021, 187-192. doi: 10.21608/bjas.2021.214410
Alloush, M., Mohamed, M., Idris, Y., Hussaein, Y. (2021). 'Evaluation of the Role of Planned Conservative Surgery for Management of Morbidly Adherent Placenta', Benha Journal of Applied Sciences, 6(6), pp. 187-192. doi: 10.21608/bjas.2021.214410
Alloush, M., Mohamed, M., Idris, Y., Hussaein, Y. Evaluation of the Role of Planned Conservative Surgery for Management of Morbidly Adherent Placenta. Benha Journal of Applied Sciences, 2021; 6(6): 187-192. doi: 10.21608/bjas.2021.214410
Evaluation of the Role of Planned Conservative Surgery for Management of Morbidly Adherent Placenta
Obstetrics and Gynecology, Dept., Faculty of Medicine, Benha Univ., Benha, Egypt
Abstract
Background: Placenta accreta, sometimes known as the "Obstetricians Nightmare," becomes the most problematic condition during the third stage of delivery. Placenta accreta is characterised by major persistent bleeding, blood loss of 3 to 5 litres, DIC, adult respiratory distress syndrome, large blood transfusion, electrolyte imbalance and renal failure. In this situation, even though a hysterectomy may save a woman's life, surgery comes with a host of risks, including damage to vital organs like the ureters and bladder, loss of fertility, and psychological stress. Thirty-eight percent of women who have peripartum hysterectomy do so due to placenta accreta. Maternal mortality may occur despite strong planning, discipline control, and transfusion management. Obstetricians have developed a range of conservative approaches for placenta accreta treatment due to the need of fertility preservation and uterine preservation in many patients. According to the study's goal, planned conservative surgery for morbidly adherent placenta management may minimise maternal mortality and morbidity while improving quality of life. Methods: Fifty individuals having a clinical diagnosis of MAP were enrolled in this prospective trial. Between June 2019 and March 2021, planned conservative surgery was performed at Benha University Hospital's Obstetrics and Gynecology Department in Benha, Egypt. After conservative surgery failed in 16% of instances, patients had C/S and myometrial excision of the region of the uterus occupied by an attached placenta. Of those, 56% underwent C/S+bilateral uterine artery ligation. Of those, 28% underwent hysterectomy. When it came to pregnancy-related issues, 84% of women were free of them, but 16% had bladder damage, and 96% were free of difficulties, but 4% had ureter damage. Ninety-four percent of pregnancies ended in singletons, with three percent (three occurrences) in twin pregnancies, and the average birth weight was 2.75 kilogrammes (kg). There were 2% IUFD admitted to the nursery, 28% admitted to the incubator and 70% released in good condition according to perinatal mortality, the death rate being 13% (6 instances). To sum up, conservative management is a choice for patients who have been appropriately advised and prepared, especially for women who desire the possibility of future pregnancy and who agree to careful follow up in facilities with suitable technology and resources, especially
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