Generic placeholder image

Current Women`s Health Reviews

Author(s): Suskhan Djusad*, Mohammad Adya Firmansha Dilmy, Rendy Adhitya Pratama, Yuditiya Purwosunu, Yudianto Budi Saroyo and Raden Muhammad Ali Fadhly

DOI: 10.2174/0115734048272591240131103426

DownloadDownload PDF Flyer Cite As
Preoperative and Intraoperative Factors as Predictors for Urological Injuries in Patients with Placenta Accreta Spectrum

Article ID: e120224226883 Pages: 6

  • * (Excluding Mailing and Handling)

Explore Articles
About Journal
For Authors
For Editors
For Reviewers

Abstract

Introduction/Background: Placenta accreta is an abnormal total or partial invasion of the trophoblast to the myometrium of the uterus, with a prevalence of 1 in 1000 births globally in 2018. Surgical treatment of PAS is known to have a high risk of urological injury. No study reports preoperative and intraoperative factors related to urological injury, especially in Indonesia.

Method: A case-control study was conducted at Cipto Mangunkusumo General Hospital, Indonesia. Data were obtained through medical records dated from January 2012 to December 2020. Pregnant women with PAS treated with surgical management were recruited. The selection of the case group consists of participants with urological injuries, while the control group involves participants with no urological injuries. The case and control groups were matched according to the general characteristics with a ratio of 1:1.

Results: Significant differences between groups were found in preoperative factors (history of urological symptoms, USG examination) and intraoperative factors (blood loss, multidisciplinary team, percreta placental invasion). Multivariate analysis showed an association between the history of urological symptoms and intraoperative bleeding to urological injury.

Conclusion: Preoperative factors such as ultrasonography examination and history of urological symptoms, along with intraoperative factors such as blood loss, multidisciplinary team, and degree of the placental invasion, were associated with urological injury in surgically treated PAS.

Keywords: Predictive factors, placenta accreta spectrum, urological injury, hematuria, fistula, hysterectomy.

[1]
Cahill, A.G.; Beigi, R.; Heine, R.P.; Silver, R.M.; Wax, J.R. Placenta accreta spectrum. Am. J. Obstet. Gynecol., 2018, 219(6), B2-B16.
[http://dx.doi.org/10.1016/j.ajog.2018.09.042] [PMID: 30471891]
[2]
Farquhar, C.M.; Li, Z.; Lensen, S.; McLintock, C.; Pollock, W.; Peek, M.J.; Ellwood, D.; Knight, M.; Homer, C.S.E.; Vaughan, G.; Wang, A.; Sullivan, E. Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: A case–control study. BMJ Open, 2017, 7(10), e017713.
[http://dx.doi.org/10.1136/bmjopen-2017-017713] [PMID: 28982832]
[3]
Goh, W.A.; Zalud, I. Placenta accreta: Diagnosis, management and the molecular biology of the morbidly adherent placenta. J. Matern. Fetal Neonatal Med., 2016, 29(11), 1795-1800.
[PMID: 26135782]
[4]
Garmi, G.; Salim, R. Epidemiology, etiology, diagnosis, and management of placenta accreta. Obstet. Gynecol. Int., 2012, 2012, 1-7.
[http://dx.doi.org/10.1155/2012/873929] [PMID: 22645616]
[5]
Tam Tam, K.B.; Dozier, J.; Martin, J.N., Jr Approaches to reduce urinary tract injury during management of placenta accreta, increta, and percreta: A systematic review. J. Matern. Fetal Neonatal Med., 2012, 25(4), 329-334.
[http://dx.doi.org/10.3109/14767058.2011.576720] [PMID: 23003574]
[6]
Engelsgjerd, J.S.; LaGrange, C.A. Ureteral injury. In: StatPearls; StatPearls Publishing: Treasure Island, FL, 2020.
[7]
Tarney, C. Bladder injury during cesarean delivery. Curr. Womens Health Rev., 2014, 9(2), 70-76.
[http://dx.doi.org/10.2174/157340480902140102151729] [PMID: 24876830]
[8]
Ahmed, S.R.; Ellah, M.A.A.; Mohamed, O.A.; Eid, H.M. Prepregnancy obesity and pregnancy outcome. Int. J. Health Sci., 2009, 3(2), 203-208.
[PMID: 21475538]
[9]
Osler, M.; Daugbjerg, S.; Frederiksen, B.L.; Ottesen, B. Body mass and risk of complications after hysterectomy on benign indications. Hum. Reprod., 2011, 26(6), 1512-1518.
[http://dx.doi.org/10.1093/humrep/der060] [PMID: 21467207]
[10]
Kyozuka, H.; Yamaguchi, A.; Suzuki, D.; Fujimori, K.; Ho-soya, M.; Yasumura, S.; Yokoyama, T.; Sato, A.; Hashimoto, K. Risk factors for placenta accreta spectrum: Findings from the Japan environment and Children’s study. BMC Pregnancy Childbirth, 2019, 19(1), 447.
[http://dx.doi.org/10.1186/s12884-019-2608-9] [PMID: 31775687]
[11]
Murji, A.; Lam, M.; Allen, B.; Richard, L.; Shariff, S.Z.; Austin, P.C.; Callum, J.; Lipscombe, L. Risks of preoperative anemia in women undergoing elective hysterectomy and my-omectomy. Am. J. Obstet. Gynecol., 2019, 221(6), 629.e1-629.e18.
[http://dx.doi.org/10.1016/j.ajog.2019.07.018] [PMID: 31310749]
[12]
Rac, M.; Dashe, J.; Wells, C.; Moschos, E.; Mcintire, D.; Twickler, D. Ultrasound predictors of placental invasion: The placenta accreta index. Am. J. Obstet. Gynecol., 2014, 212(3), 343.e1-343.e7.
[PMID: 25446658]
[13]
Putri, I.F.; Ariadi, A. The relationship between the placenta accreta index (PAI) score and the incidence of placenta accreta in patients giving birth in the obstetrics department of RSUP.Dr.M. Djamil Padang. Andalas Obstetrics Gynecology J., 2018, 2(2), 78-82.
[14]
Washecka, R.; Behling, A. Urologic complications of placenta percreta invading the urinary bladder: A case report and review of the literature. Hawaii Med. J., 2002, 61(4), 66-69.
[PMID: 12050959]
[15]
Ibrahim, M.A.; Liu, A.; Dalpiaz, A.; Schwamb, R.; Warren, K.; Khan, S.A. Urological manifestations of placenta percreta. Curr. Urol., 2015, 8(2), 57-65.
[http://dx.doi.org/10.1159/000365691] [PMID: 26889119]
[16]
Konijeti, R.; Rajfer, J.; Askari, A. Placenta percreta and the urologist. Rev. Urol., 2009, 11(3), 173-176.
[PMID: 19918343]
[17]
Phipps, M.G.; Watabe, B.; Clemons, J.L.; Weitzen, S.; Myers, D.L. Risk factors for bladder injury during cesarean delivery. Obstet. Gynecol., 2005, 105(1), 156-160.
[http://dx.doi.org/10.1097/01.AOG.0000149150.93552.78] [PMID: 15625157]
[18]
Al-Shahrani, M. Bladder Injury during Cesarean Section: A Case Control Study for 10 Years. Bahrain Med. Bull., 2012, 34(3)
[19]
Einerson, B.D.; Silver, R.M. Multidisciplinary teams in the management of placenta accreta spectrum disorders. Curr. Obstet. Gynecol. Rep., 2019, 8(3), 80-85.
[http://dx.doi.org/10.1007/s13669-019-00264-x]
[20]
Smith, Z.L.; Sehgal, S.S.; Van Arsdalen, K.N.; Goldstein, I.S. Placenta percreta with invasion into the urinary bladder. Urol. Case Rep., 2014, 2(1), 31-32.
[http://dx.doi.org/10.1016/j.eucr.2013.11.010] [PMID: 26955539]