Minimizing surgical blood loss at cesarean hysterectomy for placenta previa with evidence of placenta increta or placenta percreta: the state of play in 2020

Zhu

et al. 2021

Preprint

Objective The present study investigated whether first trimester mean arterial blood pressure (MAP) differed among pregnancies with placenta accreta and healthy pregnancies. Methods We recruited 152 pregnant females from 1 January 2016 to 30 January 2020 in the Affiliated Hospital of Jining Medical University in this study, including 41 cases of placenta accreta pregnancies and 111 cases of BMI- and age-matched healthy pregnant controls. First trimester MAPs were acquired from laboratory data files of the Affiliated Hospital of Jining Medical University. Multiple logistic regression analysis was used to analyze the probable risk predictor of placenta accreta. Results The performance of MAP was lower in healthy pregnancies. The MAP of the placenta accreta group was significantly higher than that of the control group (p = 0.001 < 0.05). Our results also showed that MAP was significantly positively associated with placenta accreta after adjusting for age, BMI, fertilization type, gestational week at time of blood pressure measurement, and previous cesarean section history (odds ratio [OR]: 1.11; 95% confidence interval [CI]: 1.04–1.69; p = 0.0013 < 0.05). In addition, smoking during pregnancy (OR: 7.57; 95% CI: 1.41–40.72; p = 0.018 < 0.05) and previous cesarean section history (OR: 2.57; 95% CI: 1.19–5.54; p = 0.016 < 0.05) were significantly positively associated with placenta accreta. Conclusions Increased first trimester MAP was significantly positively associated with placenta accreta, suggesting the potential role of MAP in identifying high-risk pregnancies for placenta accreta. Smoking during pregnancy and previous cesarean section history may be risk factors for placenta accreta.

Section: Discussionsupporting

confidence: 67%

First trimester mean arterial blood pressure is associated with placenta accreta: a retrospective study

Zhu

et al. 2021

Preprint

“…There are parallels between the increasing number of caesarean section cases and the increasing incidence of placenta accreta [34,35]. Evidence shows that women with a history of caesarean delivery have the highest risk of developing placenta accreta [36][37][38]. In the present study, we found a signi cant positive association between previous cesarean section history and the incidence of placenta accreta.…”

Section: Discussionsupporting

confidence: 66%

Is Elevated First Trimester Mean Arterial Blood Pressure Associated With Increased Risk of Placenta Accreta?

Lin

Zhu

et al. 2021

Preprint

Purpose: The present study investigated whether first trimester mean arterial blood pressure (MAP) differed among pregnancies with placenta accreta and healthy pregnancies.Methods: We recruited 176 pregnant females totally from 1 January 2016 to 30 September 2018 in this study, as follows: 65 cases of placenta accreta and 111 cases of BMI and age matched, healthy pregnant controls. First trimester mean arterial blood pressure (MAP) were acquired from laboratory data files. Multiple logistic regression analysis were used to study analyzed the probable risk predictor of placenta accreta. Results: The performance of MAP was lower in healthy pregnancies. The MAP of the placenta accreta group was significantly higher than that of the cont rol group (p=0.001<0.05). Our results also showed that MAP was significantly positively associated with placenta accreta after adjusting for age, BMI, fertilization type, gestational week at time of blood pressure measurement, and previous cesarean section history (odds ratio [β]: 1.11; 95% confidence interval [CI]: 1.04–1.69; p=0.0013<0.05). In addition, smoking during pregnancy (β: 7.57; 95% CI: 1.41–40.72; p=0.018<0.05) and previous cesarean section history (β: 2.57; 95% CI: 1.19–5.54; p=0.016<0.05) were significantly positively associated with placenta accreta.Conclusions: Increased first trimester MAP was significantly positively associated with placenta accreta, suggesting the potential role of MAP in identifying high-risk pregnancies for placenta accreta. Smoking during pregnancy and previous cesarean section history may be risk factors for placenta accreta.

“…Thus, preparations should have been made to reduce the risk of injury and to prevent uncontrolled bleeding or incomplete resection. Therefore, we performed abdominal aortic balloon catheter placement before surgery [27].…”

Section: Discussionmentioning

confidence: 99%

Abdominopelvic leiomyoma with large ascites: a case report and literature review

Fan

Qian

et al. 2020

Preprint

BackgroundLeiomyoma of the uterus is relatively common, but uterine leiomyoma of the greater omentum is rare. Case presentationHere, we report a case of a 22-year-old woman who presented with a 3-month history of progressive abdominal distension and a hypervascular abdominopelvic mass. Due to a high serum concentration of CA125, the preoperative diagnosis was unclear. During surgery, 5 L of ascites was removed. An 18.8-cm solid mass, which was pedunculated from the uterine fundus and exhibited complex adhesion to the greater omentum, was removed. The CA125 level was reduced postoperatively, and a pathologic study confirmed that the mass was a leiomyoma that originated in the uterus.ConclusionUterine leiomyoma can share vessels with the greater omentum. This case highlights the difficulty of diagnosing pseudo-Meigs syndrome and the importance of imaging and laboratory examinations.