Cesarean Hysterectomy due to Abnormal Placentation: Mortality and Morbidity in a Tertiary Center

 Background & Objective: Due to increased rate of risk factors, the incidence of placenta accreta (PA) is increasing worldwide. This study aimed to investigate the important factors regarding the occurrence of PA, as well as outcomes and complications of Trans Abdominal Hysterectomy (TAH) in the patients with PA.  Materials & Methods: The study was performed as an observational cross-sectional study.  Between March 2011 and March 2017, 177 patients, known cases of PA that undergone TAH, were enrolled in our study. Extracted data include demographic characteristics, patient’s medical history, surgical approach and complications, such as blood loss and urologic problems.  Results: The average of maternal age and gestational age were 33.6±4.70 (range= 22-43) years and 34.6±3.16 weeks, respectively. Neither maternal age (P=0.652) nor BMI (P=0.659) had significant association with abnormal placentation. Previous history of dilation & curettage (D&C) was found in 34 patients that was not related to the occurrence of the PA (P=0.508).Twenty-one (11.9%) of the patients needed urological intervention that did not associated with placental position, skin and uterine incision (P=0.258, 0.410 and 0.219). There is no relation between amount of blood loss with gestational age (P=0.7) and number of C/S (P=0.4), gestational age (P=0.7), anesthesia (P=0.2), and curettage history (P=0.3). Conclusion:  Our mortality and morbidity rate is much lower than reported ones, indicating the high-level ability, skill and knowledge of the surgeons.

کلیدواژه ها:

Peripartum hysterectomy ، Placenta accreta ، Risk factor