Investigating the quality-of-life scale in patients with placental adhesion disorder undergoing a cesarean hysterectomy and partial uterine resection

Abstract

Objectives: This study aimed to investigate the postoperative quality-of-life of patients with placental adhesion disorder undergoing a cesarean hysterectomy and partial uterine resection.

Methods: This was a prospective study performed on 40 patients aged from 25 to 35 years. The subjects were divided into two groups based on whether the uterus was preserved or not following a cesarean hysterectomy and on partial uterine resection. The Turkish version of SF-36 Quality-of-life Scale consisting of 36 items and 8 subscales was applied to the patients.

Results: The participants had a mean age of 31.3  ±  3.2 years. The mean parity, number of cesarean sections and body mass index was 3.45, 3.22 and 29.1  ±  2.9, respectively. The mean physical function score was 83.4  ±  11.61 in the cesarean hysterectomy group and 93.67  ±  8.55 in the partial uterine resection group. A significant difference was found between the cesarean hysterectomy and partial uterine resection groups in terms of their health-related quality-of-life (p  =  0.005).

Conclusions: Patients who underwent partial uterine resection had improved health-related quality-of-life compared to patients who had a cesarean hysterectomy. Choosing uterus-preserving surgery in suitable patients by evaluating the degree of placental adhesion and adhesion size may have a positive effect on the quality-of-life after surgery.

Keywords

• cesarean hysterectomy
• partial uterine resection
• placenta accreta
• placental adhesion disorder

References

1. 1. Srisajjakul S, Prapaisilp P, Bangchokdee S. MRI of placental adhesive disorder. Br J Radiol 2014;87:20140294.
2. 2. Josephs SC. Obstetric and gynecologic emergencies: a review of indications and interventional techniques. Semin Intervent Radiol 2008;25:337-46.
3. 3. Society of Gynecologic Oncology; American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, Cahill AG, Beigi R, Heine RP, Silver RM, Wax JR. Placenta Accreta Spectrum. Am J Obstet Gynecol 2018;219:B2-16.
4. 4. Cuthbert F, Teixidor Vinas M, Whitby E. The MRI features of placental adhesion disorder-a pictorial review. Br J Radiol 2016;89:20160284.
5. 5. Dekan S, Linduska N. Normal and pathological placental development: MRI and pathology. In: Prayer D, ed. Fetal MRI. Berlin,Heidelberg: Springer Berlin Heidelberg; 2011:pp. 403-42.
6. 6. Chantraine F, Blacher S, Berndt S, Palacios-Jaraquemada J, Sarioglu N, Nisolle M, et al. Abnormal vascular architecture at the placental-maternal interface in placenta increta. Am J Obstet Gynecol 2012;207:188.e1-9.
7. 7. Eshkoli T, Weintraub AY, Sergienko R, Sheiner E. Placenta accreta: risk factors, perinatal outcomes, and consequences for subsequent births. Am J Obstet Gynecol. 2013;208:219.e1-7.
8. 8. Knight M; UKOSS. Peripartum hysterectomy in the UK: management and outcomes of the associated haemorrhage. BJOG 2007;114:1380-7.

9. 9. Kayem G, Davy C, Goffinet F, Thomas C, Clément D, Cabrol D. Conservative versus extirpative management in cases of placenta accreta. Obstet Gynecol 2004;104:531-6.
10. 10. Eller AG, Porter TF, Soisson P, Silver RM. Optimal management strategies for placenta accreta. BJOG 2009;116:648-54.
11. 11. Palacios Jaraquemada JM, Pesaresi M, Nassif JC, Hermosid S. Anterior placenta percreta: surgical approach, hemostasis and uterine repair. Acta Obstet Gynecol Scand 2004;83:738-44.
12. 12. Karaman E, Kolusarı A, Çetin O, Çim N, Alkış İ, Yıldızhan R, et al. Local resection may be a strong alternative to cesarean hysterectomy in conservative surgical management of placenta percreta: experiences from a tertiary hospital. J Matern Fetal Neonatal Med 2017;30:947-52.
13. 13. Uysal G, Tanrıdan Okcu N, Eskimez E, Yılmaz Esra. Local resection for placenta accreta spectrum: a conservative uterus sparing technique for anterior placenta accreta. Eur Res J 2019;5:50-57.
14. 14. Peng Q, Zhang W, Liu Y. Clinical application of stage operation in patients with placenta accreta after previous caesarean section. Medicine (Baltimore) 2018;97:e10842.
15. 15. Stewart AL, Hays RD, Ware JE. The MOS Short-Form General Health Survey: reliability and validity in a patient population. Med Care 1988;26:724-35.
16. 16. Koçyigit H, Aydemir O, Fisek G, Olmez N, Memis A. [The reliability and validity of the Turkish verison of Short form-36 (SF-36)]. İlaç ve Tedavi Dergisi 1999;12:102-6. [Article in Turkish]
17. 17. Zhao X, Tao Y, Du Y, Zhao L, Liu C, Zhou Y, Wei P. The application of uterine wall local resection and reconstruction to preserve the uterus for the management of morbidly adherent placenta: case series. Taiwan J Obstet Gynecol 2018;57:276-82.
18. 18. Acar H, Verit FF, Baydogan S, Cetin O, Kurdoglu M. Conservative treatment of a placenta accreta case: partial segmental uterine resection. Int J Womens Health Reproduct Sci 2016;4:84-5.
19. 19. Shabana A, Fawzy M, Refaie W. Conservative management of placenta percreta: a stepwise approach. Arch Gynecol Obstet 2015;291:993-8.
20. 20. Matsubara S. Comments on: segmental uterine wall resection for placenta accreta spectrum disorder: for what purpose? Rev Bras Ginecol Obstet 2018;40:652-3.
21. 21. Su HW, Yi YC, Tseng JJ, Chen WC, Chen YF, Kung HF, et al. Maternal outcome after conservative management of abnormally invasive placenta. Taiwan J Obstet Gynecol 2017;56:353-7.
22. 22. Cui R, Li M, Lu J, Bai H, Zhang Z. Management strategies for patients with placenta accreta spectrum disorders who underwent pregnancy termination in the second trimester: a retrospective study. BMC Pregnancy Childbirth 2018;18:298.
23. 23. Tong SY, Tay KH, Kwek YC. Conservative management of placenta accreta: review of three cases. Singapore Med J 2008;49:e156-9.
24. 24. Committee on Obstetric Practice. Committee opinion no. 529: placenta accreta. Obstet Gynecol 2012;120:207-11.
25. 25. Fox KA, Shamshirsaz AA, Carusi D, Secord AA, Lee P, Turan OM, et al. Conservative management of morbidly adherent placenta: expert review. Am J Obstet Gynecol 2015;213:755-60.
26. 26. Timmermans S, van Hof AC, Duvekot JJ. Conservative management of abnormally invasive placentation. Obstet Gynecol Surv 2007;62:529-39.
27. 27. Kuppermann M, Learman LA, Schembri M, Gregorich SE, Jackson RA, Jacoby A, et al. Contributions of hysterectomy and uterus-preserving surgery to health-related quality of life. Obstet Gynecol 2013;122:15-25.
28. 28. Matsuzaki S, Yoshino K, Endo M, Kakigano A, Takiuchi T, Kimura T. Conservative management of placenta percreta. Int J Gynecol Obstet 2018;140:299-306.