Articles Vol. 66 No. CĐ6-HNKH Bệnh viện Sản nhi Nghệ An 31/05/2025

3. EVALUATION OF THE RESULTS OF UTERUS CONSERVATION SURGERY IN PLACENTA ACCLAIMARTORS AT NGHE AN OBSTETRICS AND PEDIATRICS HOSPITAL IN 2022 - 2023

Tran Quang Hanh1,2, Le Van Hoanh1,2, Phan The Hieu1,2
1 Nghe An Maternity - Pediatric Hospital
2 Bệnh viện Sản Nhi Nghệ An
Corresponding author: drhoanh2snna@gmail.com
DOI: 10.52163/yhc.v66iCD6.2258
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Keywords
Placenta accreta one-time uterine preservation
Abstract

Objective: Describe the clinical and paraclinical characteristics of pregnant women with placenta accreta at Nghe An Obstetrics and Pediatrics Hospital and comment on the results of diagnosis and uterine preservation surgery in placenta accreta at Nghe An Obstetrics and Pediatrics Hospital in 2022 - 2023.

Subjects and methods of research: Retrospective descriptive study on 33 patients who underwent one-stage uterine conservation surgery due to placenta accreta with a gestational age > 28 weeks at Nghe An Obstetrics and Pediatrics Hospital from January 2022 to December 2023.

Results: Patients admitted to the hospital were mainly asymptomatic (48.5%), 93.9% underwent elective surgery, gestational age at surgery was mainly from 34 to 36 weeks and 6 days (57.5%). The preoperative diagnosis rates of Accreta, Increta and Percreta were 78.8%, 18.2% and 3%, respectively; the intraoperative diagnosis rates were 69.7%, 24.2% and 6.1%, respectively; in addition, the postoperative diagnosis rates by histopathology were 51.5%, 21.2% and 6.1%, respectively. The rate of uterine preservation was successful in 100% of cases. Intraoperative complications: Blood loss was mainly from 500 - 1500ml (60.6%), there was no ureteral injury during surgery, surgery time was mainly from 120 minutes to 180 minutes (63.6%). Postoperative complications: There was no postoperative bleeding. There were 6.1% of mild postoperative infections that were treated with internal medicine. The maternal outcome was 100% survival, healthy upon discharge. The infant outcome was 32/33 healthy babies after treatment in the Neonatal Unit.

Conclusion: Through a study of 33 cases of one-stage uterine preservation surgery in RCRL with a preservation rate of 100% of cases, intraoperative and postoperative complications were very rare, and the results of 100% of healthy cases upon discharge from the hospital demonstrated that one-stage uterine preservation surgery due to placenta accreta is a method of uterine preservation with a high success rate and low complications.

References
[1]
ACOG (2012) "Committee opinion no. 529: placenta accreta". Obstetrics and gynecology, 120 (1), 207. Google Scholar
[2]
O'brien John M, Barton John R, Donaldson Elvis S (1996) "The management of placenta percreta: conservative and operative strategies". American journal of obstetrics and gynecology, 175 (6), 1632-1638. Google Scholar
[3]
Amsalem Hagai, Kingdom John CP, Farine Dan, Allen Lisa, Yinon Yoav, D’Souza Donna L, et al. (2011) "Planned caesarean hysterectomy versus “conserving” caesarean section in patients with placenta accreta". Journal of Obstetrics and Gynaecology Canada, 33 (10), 1005-1010. Google Scholar
[4]
ACOG (2018) "Obstetric Care Consensus No. 7 Summary: Placenta Accreta Spectum". Obstetrics & Gynecology: December 2018 - Volume 132 - Issue 6 - p 1519-1521. Google Scholar
[5]
Huỳnh Nguyễn Khánh Trang (2012) "Rau cài răng lược trên Rau tiền đạo có vết mổ cũ lấy thai". Yhọc thực hành. Tập 16 - số 2. Google Scholar
[6]
Lê Thị Thu Hà (2013) Kết quả thai kỳ các trường hợp rau cài răng lược và các yếu tố liên quan tại Bệnh viện Từ Dũ từ 06/2012 đến 06/2013. Google Scholar
[7]
Nguyễn Đức Hinh (1999) “So sánh mổ lấy thai vì RTĐ ở 2 giai đoạn 1989-1990 và 1993-1994 tại BVBMTSS”. Tạp chí thông tin y dược, Số đặc biệt chuyên đề Sản phụ khoa (12/1999).1999:107-111. Google Scholar
[8]
Nguyễn Liên Phương, Trần Danh Cường, Vũ Bá Quyết (2017), “Nhận xét về chẩn đoán và xử trí rau cài răng lược tại Bệnh viện Phụ sản Trung Ương năm”. Tạp chí phụ sản, tập 16 số 1 (2018). Google Scholar
[9]
Phạm Thị Xuân Trang (2019) “Đánh giá hiệu quả của phẫu thuật bảo tồn tử cung một thì trong nhau cài răng lược tại Bệnh viện Từ Dũ”. Luận văn chuyên khoa cấp II. Trường đại học Y dược Thành phố Hồ Chí Minh. Google Scholar
[10]
Lê Thị Năm (2022) “Nghiên cứu các trường hợp bảo tồn tử cung trong mổ lấy thai bệnh lý rau cài răng lược tại Bệnh viện phụ sản Hà Nội”. Luận văn chuyên khoa cấp II. Trường Đại học Y Hà Nội. Google Scholar