gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Ureteric dissection before uterine artery clamping in Caesarean hysterectomy for morbidly adherent placenta; Cohort study


Author(s): Mohamed S. Khallaf*, Walaa A. Elsahlmy, Nashwa Elsaid and Marawan Elkady

Caesarean hysterectomy (CH) is a standard treatment for placenta accreta spectrum (PAS) but it sometimes causes bladder/ureter injury. We attempted to test whether ureter dissection reduces the incidence of bladder/ureter injury at CH for PAS.

Methods: Patients with CH for PAS (n=140) was divided into two groups: ureter dissection (+) vs. (-). We compared the perinatal and surgical outcomes between the two groups.

Results: Two groups showed the same background characters: parity, frequency of previous miscarriages, or indication for hysterectomies. No significant differences in outcomes were observed between the two groups: operative time, perioperative blood loss, drop of hemoglobin, number of transfused RBC/plasma, or hospital-stay length. The following morbidities did not differ between the two groups: bladder/ureter/bowel injury, wound complications, ICU admission, and maternal mortality.

Conclusion: Ureteric dissection did not reduce bladder/ureter injury in CH for PAS.