Short and Intermediate Term Outcomes of Uterine Conservation After Cesarean Section in Cases of Placenta Accreta Spectrum

What this Trial Is About

Researchers are studying women with placenta accreta spectrum (PAS) who have undergone uterine conservation during cesarean delivery. The study aims to evaluate the immediate success of preserving the uterus, including measuring blood loss and transfusion needs, and to follow patients over time to assess menstrual return, uterine abnormalities, and related symptoms. This research focuses on short- and intermediate-term outcomes after cesarean section for PAS to better understand the procedure's effects. The treatment involves surgically delivering the fetus by incising the uterus above the placenta bulge, followed by administration of Carbetocin to aid uterine contraction. The uterine wall defect is repaired with running sutures, and if excessive bleeding occurs, additional procedures like internal iliac artery ligation may be used. Three months after delivery, all patients receive ultrasound assessments, and symptomatic patients or those with abnormal ultrasound findings undergo outpatient hysteroscopy to evaluate uterine health. Participants provide detailed medical and obstetric history, undergo physical exams and laboratory tests, and receive sonographic evaluations before surgery. During and after surgery, researchers record operative details, blood loss, transfusions, and complications. Follow-up includes monitoring return of menses, menstrual abnormalities, pelvic pain, uterine defects like isthmocele, and intrauterine adhesions between 2 weeks and 6 months post-surgery. Outcomes such as blood loss, surgical time, and hospital stay are also measured, with data collection extending up to 10 days post-operation and follow-up continuing for several months.

Placenta Accreta Spectrum Outcome After Uterine Conservation