Objective To create a model for prediction of success of uterine‐preserving procedures in women with placenta accreta spectrum (PAS). Methods PAS‐ID is a multicenter study that included 11 centers from 9 countries. Women with PAS, who were managed between January 1, 2010 and December 31, 2019, were retrospectively included. Data were split into model development and validation cohorts, and a prediction model was created using logistic regression. Main outcome was success of uterine preservation. Results Out of 797 women with PAS, 587 were eligible. Uterus‐preserving procedures were successful in 469 patients (79.9%). Number of previous cesarean sections (CS) was inversely associated with management success (adjusted odds ratio [aOR] 0.02, 95% confidence interval [CI] 0.001–3.63 with five previous CS). Other variables were complete placental invasion (aOR 0.14, 95% CI 0.05–0.43), type of CS incision (aOR 0.04, 95% CI 0.01–0.25 for classical incision), compression sutures (aOR 2.48, 95% CI 1.00–6.16), accreta type (aOR 3.76, 95% CI 1.13–12.53), incising away from placenta (aOR 5.09, 95% CI 1.52–16.97), and uterine resection (aOR 102.57, 95% CI 3.97–2652.74). Conclusion The present study provides a prediction model for success of uterine preservation, which may assist preoperative and intraoperative decisions, and promote incorporation of uterine preservation procedures in comprehensive PAS protocols.

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Abstrak Tujuan : Penelitian ini akan dilakukan untuk identifikasi prevalensi dan faktor risiko ibu terhadap angka kejadian IUGR di Rumah Sakit Umum Penidikan (RSUP) Dr. Hasan Sadikin Bandung. Metode : Penelitian ini menggunakan desain deskriptif retrospektif menggunakan data sekunder dengan melihat data rekam medik rawat inap pasien hamil dengan IUGR yang lahir di RSUP Dr. Hasan Sadikin Bandung periode bulan Januari 2018 – Desember 2019 berdasarkan kriteria inklusi dan eksklusi. Hasil : Prevalensi kasus IUGR di RSUP Hasan Sadikin Bandung adalah 76,16 orang per 1000 kehamilan. Karakteristik pasien dengan diagnosis IUGR terbanyak pada usia 21-34 tahun (64,32%), dengan paritas paling banyak pada primipara dengan total 147 kasus (79,45%). Faktor Risiko IUGR terdiri dari nilai BMI terbanyak dengan 86 subjek (46.5%) memiliki nilai BMI di atas batas normal. Tiga puluh lima subjek penelitian (18.9%) memiliki riwayat merokok, sementara 15 pasien (8.1%) memiliki riwayat mengonsumsi alkohol. Penyulit dalam kehamilan dengan PEB sebagai penyakit penyulit terbanyak. 28 pasien (15,1%). Pasien memiliki riwayat penyakit kronis 25 orang (13,5%) di antaranya mempunyai riwayat hipertensi kronis. Mayoritas dari seluruh pasien bersekolah hingga jenjang sekolah menengah. Kesimpulan : Prevalensi kasus IUGR di RSUP Hasan Sadikin Bandung adalah 76,16 orang per 1000 kehamilan. Karakteristik pasien terbanyak pada usia 21-34 tahun (64,32%), dengan paritas paling banyak pada primipara dengan total 147 kasus (79,45%). Kata kunci : Prevalensi, Intrauterine Growth Restriction, Faktor Risiko

Objective To determine if treatment with pravastatin prevents preeclampsia in pregnant patients at risk for preeclampsia. Material & Methods The study was performed in four major tertiary hospitals in Surabaya, Bandung, and Makassar between 2017-2021. Pregnant women at high risk of developing preeclampsia were recruited and randomized into an intervention group and control group. The control group received low dose aspirin (80 mg) and calcium (1 g) daily, while the intervention group received additional pravastatin (20 mg twice daily) started from 14-20 weeks’ gestation until delivery. The pregnancy was followed until delivery, and the clinical data was collected. The primary outcome was the occurrence of preeclampsia. Result A total of 173 people participated in this study, including 86 in the control group and 87 in the pravastatin group. The pravastatin group had a significantly lower rate of preterm preeclampsia (13.8% vs 26.7%; p=0.034; (OR=0.034, 95% CI: 0.202-0.905) and preterm birth (16.1 % vs. 36 %; p=0.003; OR= 0.340, 95% CI: 0.165-0.7), mostly indicated preterm birth. Preeclampsia occurs later in the pravastatin group than in the control group (36.39+2.32 vs 34.89+3.38 weeks, p=0.048). Overall the pravastatin group had better perinatal outcomes. Neonates with low Apgar scores (<7) at 1 minute (5.7% vs 25.6%, p=0.000) and 5 minutes (2.3% vs 25.6%, p=0.028) were significantly less common in the pravastatin group. Additionally, the rate of low birthweight babies (< 2500g) was lower in pravastatin group (27.6% vs 40.7%; p= 0.069). Conclusion Pravastatin (20 mg bid) significantly reduces the risk for preterm preeclampsia and preterm birth in women at a high risk of developing preeclampsia.