Short term follow up for morphological cervical changes in cases of placenta accreta managed by cervical advancement as a natural tamponade

Abstract

Background: Death as a result of pregnancy remains the chief cause of premature mortality worldwide. Placenta accreta spectrum (PAS) disorders have become a significant lifethreatening obstetrical issue due to their increased incidence. Placenta accreta and placenta previa are considered important causes of PPH. In 2007, Dawlatly and his colleagues described for the first time a simple technique of suturing an inverted lip of the cervix over the bleeding placental bed that was successful in controlling the bleeding and saving the patient's life. Our study was conducted to evaluate the impact of the cervical technique and discuss cervical changes after short-term follow-up of cases who were managed by this technique. Methods: Our study was conducted among a total of 140 pregnant women between June 2021 and July 2022. Follow up was done after 3 months for all participating women who were diagnosed with placenta previa or accreta. 70 cases who were diagnosed with placenta accreta and subjected to the cervical advancement technique, and 70 cases who were diagnosed with placenta previa and not subjected to cervical advancement technique at Minia University Mternity Hospital. Results: With a p-value of less than 0.05, the mean of the cervical length, the inner-to-inner diameter, the cervical shape and the position of the cervix show a statistically significant difference between the two included groups. Conclusion: cervix isn't abnormally affected in cases of placenta accreta when managed by the cervical advancement technique.