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Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Research Article

Preoperative and Intraoperative Factors as Predictors for Urological Injuries in Patients with Placenta Accreta Spectrum

In Press, (this is not the final "Version of Record"). Available online 12 February, 2024
Author(s): Suskhan Djusad*, Mohammad Adya Firmansha Dilmy, Rendy Adhitya Pratama, Yuditiya Purwosunu, Yudianto Budi Saroyo and Raden Muhammad Ali Fadhly
Published on: 12 February, 2024

Article ID: e120224226883

DOI: 10.2174/0115734048272591240131103426

open access plus

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


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