Evidence map›Paper›PMID 39358706›Full record

ArticleBMC pregnancy and childbirth2024

Cesarean hysterectomy in pregnancies complicated with placenta previa accreta: a retrospective hospital-based study.

Yongchi Zhan, Enfan Lu, Tingting Xu, Guiqiong Huang, Chunyan Deng, Tiantian Chen, Yuxin Ren, Xia Wu, Haiyan Yu, Xiaodong Wang

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In one paragraph

Article in BMC pregnancy and childbirth, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Yongchi ZhanDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Enfan LuKey Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.
Tingting XuDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Guiqiong HuangDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Chunyan DengDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Tiantian ChenDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Yuxin RenDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Xia WuKey Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.
Haiyan YuDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Xiaodong WangDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China. wangxd_scu@sina.com.

Funding

Science Foundation of Sichuan Province 2022YF0042
6 · The paper itself

Abstract

backgroundPlacenta previa accreta (PPA) is a severe obstetric condition that can cause massive postpartum hemorrhage and transfusion. Cesarean hysterectomy is necessary in some severe cases of PPA to stop the life-threatening bleeding, but cesarean hysterectomy can be associated with significant surgical blood loss and major complications. The current study is conducted to investigate the potential risk factors of excessive blood loss during cesarean hysterectomy in women with PPA.

methodsThis is a retrospective study including singleton pregnancies after 28 weeks of gestation in women with placenta previa and pathologically confirmed placenta accreta spectrum who received hysterectomy during cesarean sections. A total of 199 women from January 2012 to August 2023 were included in this study and were divided into Group 1 (estimated surgical blood loss (EBL) ≤ 3500 mL, n = 103) and Group 2 (EBL > 3500 mL, n = 96). The primary outcome was defined as an EBL over 3500 mL. Baseline characteristics and surgical outcomes were compared between the two groups. A multivariate logistic regression model was applied to find potential risk factors of the primary outcome.

resultsMassive surgical blood loss was prevalent in our study group, with a median EBL of 3500 mL. The multivariate logistic analysis showed that emergency surgery (OR 2.18, 95% CI 1.08-4.41, p = 0.029), cervical invasion of the placenta (OR 2.70, 95% CI 1.43-5.10, p = 0.002), and intraoperative bladder injury (OR 5.18, 95% CI 2.02-13.28, p = 0.001) were all associated with the primary outcome. Bilateral internal iliac arteries balloon occlusion (OR 0.57, 95% CI 0.34-0.97) and abdominal aortic balloon occlusion (OR 0.33, 95% CI 0.19-0.56) were negatively associated with the primary outcome.

conclusionsEmergency surgery, cervical invasion of the placenta, and intraoperative bladder injury were potential risk factors for additional EBL during cesarean hysterectomy in women with PPA. Future prospective studies are needed to confirm the effect of intra-arterial balloon occlusion in cesarean hysterectomy of PPA.

Indexed as

Blood Loss, SurgicalCesarean SectionHysterectomyPlacenta AccretaPlacenta PreviaAdultFemaleHumansPostpartum HemorrhagePregnancyRetrospective StudiesRisk FactorsBalloon occlusionCesarean hysterectomyHemorrhagePlacenta previa

Identifiers

PMID39358706
PMCPMC11445944

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.