Morbidly adherent placenta as a cause of peripartum hysterectomy in the Slovak Republic in the years 2012–2020
Authors:
A. Adamec
; M. Vargová
; D. Kotríková
; Liam McCullough
; D. Kanásová
; J. Daniš
; R. Gabal
; A. Krištúfková
; Z. Nižňanská
; Miroslav Korbeľ
Authors‘ workplace:
I. gynekologicko-pôrodnícka klinika LF UK a UN Bratislava, Slovenská republika
Published in:
Ceska Gynekol 2023; 88(5): 321-327
Category:
Original Article
doi:
https://doi.org/10.48095/cccg2023321
Overview
Objective: The main aim of this study was to analyze the cases of peripartum hysterectomy associated with morbidly adherent placenta in the Slovak Republic. Materials and methods: Cases of morbidly adherent placenta managed by peripartum hysterectomy in the Slovak Republic between January 2012 and December 2020 were retrospectively analyzed. Data were obtained from the standardized anonymous questionnaires. Results: The incidence of morbidly adherent placenta was 0.39 per 1,000 births. A total of 151 (89.9%) women with morbidly adherent placenta were managed by peripartum hysterectomy (38.0% of all peripartum hysterectomies). Placenta accreta, increta and percreta were present in 56.3%, 28.5% and 15.2%, respectively. Placenta previa was present in 60 (39.7%) cases. Up to 112 (74.2%) cases of morbidly adherent placenta were diagnosed at the time of delivery. Hysterectomy was preceded by unsuccessful uterus-saving procedure in 23 (15.2%) of cases. The median of estimated blood loss was 1,500 mL. A packed red blood cells transfusion was used in 138 (91.4%), fresh frozen plasma in 118 (78.2%), fibrinogen concentrate in 39 (25.8%) and tranexamic acid in 25 (16.6%) women. A total of 58 (38.4%) women required admission to an intensive care unit. The mortality rate was 1.3%. Conclusion: In recent years, there was an increase in the incidence of morbidly adherent placenta, peripartum hysterectomy in the Slovak Republic, along with an increase in caesarean section rates, too. Case analysis highlights the need to improve the prenatal diagnosis and management of morbidly adherent placenta.
Keywords:
peripartum hysterectomy – placenta praevia – caesarean section – morbidly adherent placenta – severe peripartum haemorrhage
Sources
1. Joseph KS, Rouleau J, Kramer MS et al. Investigation of an increase in postpartum haemorrhage in Canada. BJOG 2007; 114 (6): 751–759. doi: 10.1111/j.1471-0528.2007.01316.x.
2. Knight M. Peripartum hysterectomy in the UK: management and outcomes of the associated haemorrhage. BJOG 2007; 114 (11): 1380–1387. doi: 10.1111/j.1471-0528.2007.01507.x.
3. Jauniaux E, Ayres-de-Campos D. FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel. FIGO consensus guidelines on placenta accreta spectrum disorders: introduction. Int J Gynaecol Obstet 2018; 140 (3): 261–264. doi: 10.1002/ijgo.12406.
4. Kristufkova A, Borovsky M, Danis J et al. Analyses of severe acute maternal morbidity in Slovakia during years 2012–2016. Bratisl Lek Listy 2019; 120 (9): 691–695. doi: 10.4149/BLL_ 2019_116.
5. Krištúfková A, Korbeľ M, Daniš J et al. Analýza závažnej akútnej materskej morbidity v Slovenskej republike v rokoch 2016 a 2017. Gynekol prax 2020; 84 (2): 92–98.
6. Korbeľ M, Krištúfková A, Daniš J et al. Materská morbidita s Slovenskej republike v roku 2018. II. – perineálna a závažná materská morbidita. Gynekol prax 2020; 18 (2): 78–83.
7. Korbeľ M, Adamec A, Vargová M et al. Materská morbidita s Slovenskej republike v roku 2019. II. – perineálna a závažná materská morbidita. Gynekol prax 2021; 19 (2): 82–87.
8. Korbeľ M, Adamec A, Vargová M et al. Materská morbidita s Slovenskej republike v roku 2020. II. – perineálna a závažná materská morbidita. Gynekol prax 2022; 20 (1): 28–33.
9. Korbeľ M, Krištúfková A, Daniš J et al. Severe maternal morbidity in the Slovak Republic in the years 2012–2018. Ceska Gynekol 2022; 87 (2): 93–99. doi: 10.48095/cccg202293.
10. Adamec A, Korbeľ M, Krištúfková A et al. Analýza prípadov peripartálnej hysterektómie v Slovenskej republike v rokoch 2012–2016. Gynekol prax 2020; 18 (2): 98–102.
11. Kallianidis AF, Rijntjes D, Brobbel C et al. Incidence, indications, risk factors, and outcomes of emergency peripartum hysterectomy worldwide: a systematic review and meta-analysis. Obstet Gynecol 2023; 141 (1): 35–48. doi: 10.1097/AOG.0000000000005022.
12. Kallianidis AF, Maraschini A, Danis J et al. Epidemiological analysis of peripartum hysterectomy across nine European countries. Acta Obstet Gynecol Scand 2020; 99 (10): 1364–1373. doi: 10.1111/aogs.13892.
13. Jauniaux E, Bunce C, Grønbeck L et al. Prevalence and main outcomes of placenta accreta spectrum: a systematic review and meta-analysis. Am J Obstet and Gynecol 2019; 221 (3): 208–218. doi: 10.1016/j.ajog.2019.01.233.
14. Fitzpatrick KE, Sellers S, Spark P et al. The management and outcomes of placenta accreta, increta, and percreta in the UK: a population-based descriptive study. BJOG 2014; 121 (1): 62–71. doi: 10.1111/1471-0528.12405.
15. Thurn L, Lindqvist P, Jakobsson M et al. Abnormally invasive placenta-prevalence, risk factors and antenatal suspicion: results from a large population-based pregnancy cohort study in the Nordic countries. BJOG 2016; 123 (8): 1348–1355. doi: 10.1111/1471-0528.13547.
16. Jauniaux E, Chantraine F, Silver RM et al. FIGO consensus guidelines on placenta accreta spectrum disorders: epidemiology. Int J Gynaecol Obstet 2018; 140 (3): 265–273. doi: 10.1002/ijgo.12407.
17. Korbeľ M, Adamec A, Vargová M et al. Audit cisárskeho rezu v Slovenskej republike v rokoch 2007–2019. Gynekol prax 2021; 19 (2): 89–96.
18. Korbeľ M, Adamec A, Vargová M et al. Materská morbidita v Slovenskej republike v roku 2020. I. – operačné pôrody. Gynekol prax 2022; 20 (1): 23–27.
19. Silver RM, Landon MB, Rouse DJ et al. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol 2006; 107 (6): 1226–1232. doi: 10.1097/01.AOG.000 0219750.79480.84.
20. Jauniaux E, Grønbeck L, Bunce C et al. Epidemiology of placenta previa accreta: a systematic review and meta-analysis. BMJ Open 2019; 9 (11): e031193. doi: 10.1136/bmjopen-2019-031193.
21. Morel O, van Beekhuizen HJ, Braun T et al. Performance of antenatal imaging to predict placenta accreta spectrum degree of severity. Acta Obstet Gynecol Scand 2021; 100 (Suppl 1): 21–28. doi: 10.1111/aogs.14112.
22. WHO. Updated WHO Recommendation on Tranexamic Acid for the Treatment of Postpartum Haemorrhage. Highlights and Key Messages from the World Health Organization’s 2017 Global Recommendation. 2017 [online]. Available from: https: //apps.who.int/iris/bitstream/handle/10665/259379/WHO-RHR-17.21-eng.pdf; sequence=1.
23. Hofer S, Blaha J, Collins PW et al. Haemostatic support in postpartum haemorrhage: a review of the literature and expert opinion. Eur J Anaesthesiol 2023; 40 (1): 29–38. doi: 10.1097/EJA. 0000000000001744.
24. Pařízek A, Binder T, Bláha J et al. Diagnostika a léčba peripartálního život ohrožujícího krvácaní, Česko-slovenský mezioborový konsenzus, doporučený postup. Ceska Gynekol 2018; 83 (2): 150–157.
25. Krištúfková A, Borovský M, Záhumenský J. Prevencia, diagnostika a liečba peripartálneho krvácania 1. revízia. Štandardné postupy. Ministerstvo zdravotníctva Slovenskej republiky 2022 [online]. Dostupné z: https: //www.stand ardnepostupy.sk/standardy-gyneklologia-a- porodnictvo/.
Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
Czech Gynaecology
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