The higher incision at upper part of lower uterine segment in caesarean section can decrease the incidence of placenta accreta spectrum

Abdallah, Wael; Najib, Bernard; Atallah, David

doi:10.1016/j.mehy.2020.110228

Cited by 5 publications

(5 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Their rate has been continuously rising across various countries for the past three decades with an estimated annual increase of 4%. 1 However, WHO has recommended maintaining a cesarean section rate between 5% and 15% since 1985. 2 When indicated, cesarean section can effectively lower both perinatal and maternal morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Cesarean section rates in a tertiary referral hospital in Beirut from 2018 to 2020: Our experience using the Robson Classification

Abdallah

Tayeh

Cortbaoui

et al. 2021

Intl J Gynecology & Obste

Self Cite

View full text Add to dashboard Cite

Objective: To evaluate the cesarean section rate using the Robson Classification for the first time in Lebanon, at Hôtel-Dieu de France University Hospital, a tertiary referral center in Beirut.Methods: Routine medical record data that included all live births from January 1, 2018 to September 30, 2020 was investigated. The overall cesarean section rate was recorded, and the size, cesarean section rate, and absolute and relative contributions were calculated within each group. Results:The overall cesarean section rate was 56.8%. The highest relative contribution to this rate came from Robson groups 5, 2 and 10, respectively. A decrease in cesarean section rate was noted in 2020 among women admitted for induction of labor (groups 2 and 4) following the implementation of new department policies and the restrictions caused by the coronavirus disease 2019 pandemic. Conclusion:More than 50% of the deliveries in our department were by cesarean sections (CS). Strategies to reduce this rate should include stricter departmental policies for avoidance of unindicated primary CS and raising practitioners' and patients' awareness about trial of labor after cesarean section.

show abstract

Section: Introductionmentioning

confidence: 99%

Cesarean section rates in a tertiary referral hospital in Beirut from 2018 to 2020: Our experience using the Robson Classification

Abdallah

Tayeh

Cortbaoui

et al. 2021

Intl J Gynecology & Obste

Self Cite

View full text Add to dashboard Cite

show abstract

“…First, the transverse incision may have extended to the broad ligament. Second, the uterine smooth muscles are arranged in a vertical pattern [22] ; thus, a high vertical incision transects fewer muscle fibers, making it easier to repair. Verspyck et al [20] compared 2 surgical methods, one of which aimed to circumvent the placenta to avoid cutting through it.…”

Section: Discussionmentioning

confidence: 99%

Surgical approach could be a major factor in placenta previa outcome: A comparative retrospective study

Uwais,

Satari,

Hijazin

et al. 2023

Medicine

View full text Add to dashboard Cite

Placenta previa is associated with high morbidity and mortality rates due to major hemorrhage during surgery. Thus, a standard surgical approach with a low risk of morbidity is required. This study aimed to propose surgical steps for placenta previa with scarred uterus. All deliveries at the Al-Karak governmental hospital between January 2019 and January 2022 were retrospectively reviewed. Placenta previa cases were divided into 2 groups according to management. Group A was managed by incising the uterus at the level of the fundus to avoid disrupting the placenta, whereas group B was managed by opening the lower uterine segment and delivering the baby through the placenta after the incision. A total of 26 cases with placenta previa were included in this study. Group A (n = 12) was managed by avoiding the placenta and group B (n = 14) was managed by opening through the placenta. No differences were noted between the 2 groups regarding demographics. Patients who underwent the suggested surgical approach (Group A) had less blood loss (median = 775 cc), whereas Group B (median = 1700 cc) (P = .001) had significantly higher blood loss. The duration of hospital stay was significantly shorter in Group A (median = 2 days) than in Group B (median = 6 days) (P = .000). Incising the upper uterine segment to avoid the placenta may lead to better outcomes in terms of blood loss and its consequences.

show abstract

“…We recommend opening the upper uterine segment vertically for two main reasons. First the transverse incision may extend to the broad ligament, second the uterine smooth muscles are arranged in a vertical pattern (20) thus, in a high vertical incision we transect less muscle ber and make it easy to repair. Eric Verspyck et al compared between two surgical method one of them aims to avoid the placenta by circumventing it and avoiding the placenta was possible in 67% of the cases (16).…”

Section: Discussionmentioning

confidence: 99%

Surgical approach could be a major factor in placenta Previa outcome: a retrospective study

Uwais

Hijazin

Satari

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: Placenta previa carry high morbidity and mortality due to massive hemorrhage occur during surgery. So, there should be a standard surgical approach with less morbidity. Methods: This is a retrospective study that reviewed all deliveries in Al-karak governmental hospital between 2019–2022. Placenta previa cases were divided into two groups according to management. Group A was managed by incising the uterus at the level of fundus to avoid opening through the placenta, while Group B was managed by opening the lower uterine segment and delivering the baby through placenta after incising it. Result: This study included 26 cases of placenta previa, 12 of them (Group A) were managed by avoiding the placenta and the other 14 cases (Group B) were managed by opening through the placenta. There was no difference between the two groups in terms of age and the number of previous caesarean sections (table 1). Patients who underwent the suggested surgical approach (Group A) had less blood loss (Mdn = 775 cc) while Group B (Mdn = 1700 cc) U = 20.0 p = 0.001 was significantly higher in terms of blood loss. Similarly, the number of blood units given for Group B (Mdn = 5 units) was significantly higher than Group A (Mdn = 1 unit) U = 29.5. p = 0.005. lastly, the duration of hospital stay for Group A (Mdn = 2 days) was significantly less than Group B (Mdn = 6 days) U = 10.0. p = 0.000 Conclusion: Incising the upper uterine segment to avoid the placenta may have better outcome regarding blood loss and its consequences.

show abstract

The higher incision at upper part of lower uterine segment in caesarean section can decrease the incidence of placenta accreta spectrum

Cited by 5 publications

References 17 publications

Cesarean section rates in a tertiary referral hospital in Beirut from 2018 to 2020: Our experience using the Robson Classification

Cesarean section rates in a tertiary referral hospital in Beirut from 2018 to 2020: Our experience using the Robson Classification

Surgical approach could be a major factor in placenta previa outcome: A comparative retrospective study

Surgical approach could be a major factor in placenta Previa outcome: a retrospective study

Contact Info

Product

Resources

About