Maternal and neonatal outcomes in planned versus emergency cesarean delivery for placenta accreta spectrum: A multinational database study.
Adult
Cesarean Section
/ methods
Cohort Studies
Databases, Factual
Emergency Medical Services
Europe
Female
Gestational Age
Hemorrhage
/ surgery
Humans
Infant Health
Maternal Health
Placenta Accreta
/ surgery
Pregnancy
Pregnancy Complications
/ surgery
Pregnancy Outcome
Retrospective Studies
United States
abnormally invasive placenta
gestational age
maternal morbidity
neonatal morbidity
placenta accreta spectrum
Journal
Acta obstetricia et gynecologica Scandinavica
ISSN: 1600-0412
Titre abrégé: Acta Obstet Gynecol Scand
Pays: United States
ID NLM: 0370343
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
revised:
30
01
2021
received:
17
10
2020
accepted:
05
02
2021
pubmed:
14
3
2021
medline:
23
4
2021
entrez:
13
3
2021
Statut:
ppublish
Résumé
Placenta accreta spectrum (PAS) is a condition often resulting in severe maternal morbidity. Scheduled delivery by an experienced team has been shown to improve maternal outcomes; however, the benefits must be weighed against the risk of iatrogenic prematurity. The aim of this study is to investigate the rates of emergency delivery seen for antenatally suspected PAS and compare the resulting outcomes in the 15 referral centers of the International Society for PAS (IS-PAS). Fifteen centers provided cases between 2008 and 2019. The women included were divided into two groups according to whether they had a planned or an emergency cesarean delivery. Delivery was defined as "planned" when performed at a time and date to suit the team. All the remaining cases were classified as "emergency". Maternal characteristics and neonatal outcomes were compared between the two groups according to gestation at delivery. In all, 356 women were included. Of these, 239 (67%) underwent a planned delivery and 117 (33%) an emergency delivery. Vaginal bleeding was the indication for emergency delivery in 41 of the 117 women (41%). There were no significant differences in terms of blood loss, transfusion rates or major maternal morbidity between planned and emergency deliveries. However, the rate of maternal intensive therapy unit admission was increased with emergency delivery (45% vs 33%, P = .02). Antepartum hemorrhage was the only independent predictor of emergency delivery (aOR: 4.3, 95% confidence interval 2.4-7.7). Emergency delivery due to vaginal bleeding was more frequent with false-positive cases (antenatally suspected but not confirmed as PAS at delivery) and the milder grades of PAS (accreta/increta). The rate of infants experiencing any major neonatal morbidity was 25% at 34 Emergency delivery in centers of excellence did not increase blood loss, transfusion rates or maternal morbidity. The single greatest risk factor for emergency delivery was antenatal hemorrhage. When adequate expertise and resources are available, to defer delivery in women with no significant antenatal bleeding and no risk factors for pre-term birth until >36
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
41-49Investigateurs
Pavel Calda
(P)
Fredric Chantraine
(F)
Johannes J Duvekot
(JJ)
Karin A Fox
(KA)
Lene Gronbeck
(L)
Wolfgang Henrich
(W)
Pasquale Martinelli
(P)
Jorma Paavonen
(J)
Philippe Petit
(P)
Marcus Rijken
(M)
Mariola Ropacka
(M)
Minna Tikkanen
(M)
Alexander Weichert
(A)
Katharina Weizsäcker
(K)
Informations de copyright
© 2021 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).
Références
Chantraine F , Nisolle M , Petit P , Schaaps J-P , Foidart J-M . Individual decisions in placenta increta and percreta: a case series. J Perinat Med. 2012;40:265-270.
Jauniaux E , Silver RM , Matsubara S . The new world of placenta accreta spectrum disorders. Int J Gynaecol Obstet. 2018;140:259-260.
Fitzpatrick K , Sellers S , Spark P , Kurinczuk J , Brocklehurst P , Knight M . The management and outcomes of placenta accreta, increta, and percreta in the UK: a population-based descriptive study. BJOG. 2014;121:62-71.
Eller AG , Porter TF , Soisson P , Silver RM . Optimal management strategies for placenta accreta. BJOG. 2009;116:648-654.
Al-Khan A , Gupta V , Illsley NP , et al. Maternal and fetal outcomes in placenta accreta after institution of team-managed care. Reprod Sci. 2014;21:761-771.
Shamshirsaz AA , Fox KA , Salmanian B , et al. Maternal morbidity in patients with morbidly adherent placenta treated with and without a standardized multidisciplinary approach. Am J Obstet Gynecol. 2015;212:218.e1-218.e9.
Silver RM , Fox KA , Barton JR , et al. Center of excellence for placenta accreta. Am J Obstet Gynecol. 2015;212:561-568.
Morlando M , Collins S . Placenta accreta spectrum disorders: challenges, risks, and management strategies. Int J Womens Health. 2020;12:1033-1045.
Robinson BK , Grobman WA . Effectiveness of timing strategies for delivery of individuals with placenta previa and accreta. Obstet Gynecol. 2010;116:835-842.
Collins SL , Alemdar B , van Beekhuizen HJ , et al. Evidence-based guidelines for the management of abnormally invasive placenta: recommendations from the International Society for Abnormally Invasive Placenta. Am J Obstet Gynecol. 2019;220:511-526.
Braun T , van Beekhuizen HJ , Morlando M , Morel O , Stefanovic V ; IS-PAS. Developing a database for multicenter evaluation of placenta accreta spectrum. Acta Obstet Gynecol Scand. 2021;100(Suppl. 1):7-11.
Collins SL , Stevenson GN , Al-Khan A , et al. Three-dimensional power Doppler ultrasonography for diagnosing abnormally invasive placenta and quantifying the risk. Obstet Gynecol. 2015;126:645-653.
Jauniaux E , Chantraine F , Silver RM , Langhoff-Roos J ; for the FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel. FIGO consensus guidelines on placenta accreta spectrum disorders: epidemiology. Int J Gynecol Obstet. 2018;140:265-273.
Jauniaux E , Ayres-de-Campos D , Langhoff-Roos J , Fox KA , Collins S ; FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel. FIGO classification for the clinical diagnosis of placenta accreta spectrum disorders. Int J Gynaecol Obstet. 2019;146:20-24.
Allen L , Jauniaux E , Hobson S , Papillon-Smith J , Belfort MA ; FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel. FIGO consensus guidelines on placenta accreta spectrum disorders: nonconservative surgical management. Int J Gynaecol Obstet. 2018;140:281-290.
Jauniaux E , Alfirevic Z , Bhide AG , et al. Placenta praevia and placenta accreta: diagnosis and management. Green-top Guideline No. 27a. BJOG. 2019;126(1):e1-e48.
Hobson SR , Kingdom JC , Murji A , et al. No. 383-screening, diagnosis, and management of placenta accreta spectrum disorders. J Obstet Gynaecol Can. 2019;41(7):1035-1049.
American College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine. Obstetric care consensus no. 7: placenta accreta spectrum. Obstet Gynecol. 2018;132:e259-e275.
Rac MWF , Wells CE , Twickler DM , Moschos E , McIntire DD , Dashe JS . Placenta accreta and vaginal bleeding according to gestational age at delivery. Obstet Gynecol. 2015;125:808-813.
Fishman SG , Chasen ST . Risk factors for emergent preterm delivery in women with placenta previa and ultrasound findings suspicious for placenta accreta. J Perinat Med. 2011;39:693-696.
D’Antonio F , Iacovella C , Bhide A . Prenatal identification of invasive placentation using ultrasound: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2013;42:509-517.