AB120. SOH23ABS_057. Operative management and morbidities of placenta accreta spectrum: a tertiary maternity unit’s experience
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AB120. SOH23ABS_057. Operative management and morbidities of placenta accreta spectrum: a tertiary maternity unit’s experience

Ahmed Lutfi1, Elisa Carrion1, Brendan Fitzgerald2, Richard Greene3

1Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork, Ireland; 2Department of Pathology, Cork University Hospital, Cork, Ireland; 3Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Centre, Cork University Maternity Hospital, Cork, Ireland

Background: Placenta accreta spectrum (PAS) refers to a range of invasive placental diseases and are associated with maternal morbidity. Here we describe the procedures performed and morbidities of patients with a histopathological diagnosis of PAS in our unit.

Methods: Patients with a histopathological diagnosis of PAS were identified using iLAB APEX Laboratory Information Management System in Cork University Maternity Hospital, Ireland. Search was limited to histopathology records between 1st January 2015 to 31st December 2020 inclusive. The exclusion criteria included patients with unattainable health records or where patients had antenatal care and delivery in other maternity units. Patient delivery information and outcomes were recorded.

Results: A total of 77 patients satisfied both inclusion and exclusion criteria. Approximately 64% of patients had caesarean deliveries. Manual removal of placenta was required in 25% of patients. Uterine balloon tamponade was needed in two patients and haemostatic brace sutures was needed in one patient. Hysterectomy was necessary in 8% of patients. One patient had local surgical resection. Two patients underwent postnatal uterine evacuation procedures following secondary postpartum haemorrhage. One patient underwent prophylactic pelvic vasculature balloon catheterization prior to scheduled caesarean delivery. The most common morbidity was postpartum haemorrhage (51%) and 25% of patients received a blood transfusion. The non-haemorrhagic morbidities identified were infection (10%), hypertensive disorders of pregnancy (10%), bladder injury (5%), venous thromboembolism (1%), opioid withdrawal (1%) and postnatal depression (4%).

Conclusions: PAS is a major obstetric disorder with most procedures focused on managing postpartum haemorrhage.

Keywords: Adherent placenta; histopathology; maternal morbidity; placenta accreta spectrum (PAS); postpartum haemorrhage

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-23-ab120
Cite this abstract as: Lutfi A, Carrion E, Fitzgerald B, Greene R. AB120. SOH23ABS_057. Operative management and morbidities of placenta accreta spectrum: a tertiary maternity unit’s experience. Mesentery Peritoneum 2023;7:AB120.

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