Đánh giá kết quả của phẫu thuật bảo tồn tử cung trong rau cài răng lược tại Bệnh viện Sản Nhi Nghệ An năm 2022–2023

Placenta accreta spectrum (PAS) is a severe obstetric complication with increasing incidence globally, posing significant risks to maternal health, including severe hemorrhage, hysterectomy, and even mortality. The challenge lies in managing these cases effectively while aiming to preserve fertility, which is crucial for many women. This study addresses this critical need by evaluating the outcomes of one-stage uterine conservation surgery for placenta accreta at Nghe An Obstetrics and Pediatrics Hospital. By analyzing clinical and paraclinical characteristics and surgical results, this research highlights the importance of tailored surgical approaches in improving maternal and neonatal outcomes in the context of this high-risk condition.

Obstetricians, gynecologists, maternal-fetal medicine specialists, surgeons, and medical researchers interested in managing high-risk pregnancies and uterine preservation techniques for placenta accreta.

This retrospective descriptive study investigated the clinical and paraclinical characteristics and the efficacy of one-stage uterine conservation surgery in 33 pregnant women with placenta accreta at Nghe An Obstetrics and Pediatrics Hospital between January 2022 and December 2023. The objective was to assess the outcomes of diagnosis and uterine preservation in these high-risk cases. Patients primarily presented asymptomatically (48.5%) and underwent elective surgery (93.9%), with most procedures performed between 34 and 36 weeks of gestation (57.5%). Preoperative diagnoses showed Accreta in 78.8%, Increta in 18.2%, and Percreta in 3%, aligning closely with intraoperative findings. A remarkable 100% success rate was achieved in uterine preservation. Intraoperative complications were minimal, with blood loss predominantly ranging from 500 to 1500ml (60.6%) and no ureteral injuries reported. The majority of surgeries were completed within 120 to 180 minutes (63.6%). Postoperative complications were rare, with only 6.1% experiencing mild infections treated medically. Maternal outcomes were excellent, with 100% survival and healthy discharge, and 32 out of 33 infants were healthy after neonatal care. The findings demonstrate that one-stage uterine preservation for placenta accreta is a highly successful method with a low incidence of complications, offering a valuable approach for maintaining fertility in affected women.