Evaluation of the Relationship between the Number of Cesarean Sections and Maternal and Neonatal Mortality and Morbidity in Patients with Placenta Percreta

Öz

Background: The aim of this study is to determine the level of attitudes of medical students towards scientific researches. In the study, it was also examined whether there was a significant difference between students’ attitudes towards researches according to their gender and grade levels. Materials and Methods: In this study, 110 placenta percreta patients who were delivered between January 2021 and January 2022 in the gynecology and obstetrics clinic of Harran University were includ-ed in the study. The patients were grouped according to the number of previous cesarean sections; Pregnant women's age, weeks of delivery, prepartum and postpartum blood transfusion needs, 1st and 5th minute APGAR scores of their babies, intraoperative and postoperative complications, length of hospital stay, and peri-partum invasion status according to the status of performing preventive surgery/hysterectomy were retrospectively analyzed from the file records. Results: As the number of previous cesarean section increased, the hysterectomy status of the groups formed based on the number of cesarean sections was found to be statistically significant. However, it was determined that there was no significant difference between the groups in terms of age, weeks of birth, prepartum and postpartum blood transfusion needs, 1st and 5th minute APGAR scores of infants, intraoperative and postoperative complications, and hospital stay. Conclusions: The incidence of hysterectomy increases as the number of previous cesarean sections increases in patients with placenta percreta.This situation increases the morbidity of the pa-tients.Surgeons experienced in peripartum hysterectomy and uterine devascularization maneuvers are needed to achieve optimal results when the diagnosis of placenta percreta is made Key Words: Placenta percreta, Previous cesarean section, Peripartum hysterectomy

Plasenta Perkreatalı Hastalarda Sezaryen Sayısının Maternal ve Neonatal Mortalite ve Morbidite ile İlişkisinin Değerlendirilmesi

Öz

Amaç; Bu araştırma plasenta perkreatalı hastalarda sezaryen ile doğum sayısının natal ve postnatal mortalite ve morbiditeyle ilişkisinin retrospektif karşılaştırılmasını incelemek amacıyla yapılmıştır. Yöntem: Bu çalışma Harran üniversitesi kadın hastalıkları ve doğum kliniğinde Ocak 2021- Ocak 2022 tarihleri arasında doğumu gerçekleştirilen 110 plasenta perkreata hastası çalışmaya dahil edildi. Hastaların geçirilmiş sezeryan sayısına göre gruplandırılıp; gebelerin yaşı, doğum haftaları, prepartum ve postpartum kan transfüzyon ihtiyacları, bebeklerinin 1. ve 5. dakika APGAR skorları, intraop ve postop komplikasyonları, hastanede kalış süreleri ve peripartum invazyon durumuna göre koruyucu cerrahi/histerektomi yapılma durumları dosya kayıtlarından retrospektif olarak incelendi. Bulgular: Sezeryan sayıları baz alınarak oluşturulan grupların geçirilmiş sezeryan sayısı artıkça histerektomi olma durumları istatistiksel olarak anlamlı fark bulunmuştur. Fakat gruplar arasında yaş, doğum haftaları, prepartum ve postpartum kan transfüzyon ihtiyacları, bebeklerin 1. ve 5. dakika APGAR skorları, intraop ve postop komplikasyonları ve hastanede kalış süreleri arasında anlamlı fark olmadığı belirlenmiştir. Sonuç: Plasenta perkreatalı hastalarda geçirilmiş sezaryen sayısı artıkça histerektomi olma insidansı artmaktadır. Bu durum hastaların morbiditesini artırmaktadır. Plasenta perkreata tanısı konulduğunda optimal sonuç elde edebilmek için peripartum histerektomi ve uterin devaskülarizasyon manevraları konusunda deneyimli cerrahlara ihtiyaç vardır. Yeterli tecrübe ve donanıma sahip sağlık merkezlerinde multidisipliner yaklaşımlar hayati öneme sahiptir.

Anahtar Kelimeler

• Plasenta perkreata
• geçirilmiş sezaryen öyküsü
• peripartum histerektomi

Kaynakça

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