Clinical application of stage operation in patients with placenta accreta after previous caesarean section.

Abstract

To explore the clinical value of stage operation to patients with placenta accreta after previous caesarean section (CS).Nineteen women with medium and late pregnancies diagnosed with placenta accreta after previous CS were enrolled in this retrospective study and all underwent stage operation. Postpartum hemorrhage volume, red blood cells (RBC) transfusion, uterus retention rate, postpartum complications, and menstrual recovery were analyzed to evaluate the value of stage operation in patients with placenta accreta.Four of 19 cases were performed uterus curettage after 63, 38, 56, and 52 days of CS. Total hysterectomy was performed in 2 cases after 44 and 57 days of first-stage CS. Thirteen cases had placenta well discharged after treatment with the traditional Chinese medicine (TCM) Shenghua Decoction. The uterus retention rate was 89.48% (17/19). Mean postpartum hemorrhage volume was 1594.74 ± 1134.06 (400–4500) mL, mean volume of total hemorrhage was 1878.42 ± 1276.96 (400–4500) mL, mean RBC transfusion was 868.42 ± 816.53 (0.00–2400.00) mL. Postpartum bleeding volume showed≤1000 mL in 8 patients and ≤500 mL in 4 patients.Stage operation reduces postpartum hemorrhage volume and cesarean hysterectomy morbidity in patients with placenta accreta. However, infection and late postpartum hemorrhage should be monitored closely.