Risk factors of emergency cesarean section in pregnant women with severe placenta accreta spectrum: a retrospective cohort study
IntroductionPlacenta accreta spectrum (PAS) may cause enormous and potentially life-threatening hemorrhage in the intrapartum and postpartum periods in emergency cesarean section. How to reduce the occurrence of emergency cesarean section in patients with severe PAS is the key to reducing the advers...
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| Format: | Article |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1195546/full |
| _version_ | 1797782027904221184 |
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| author | Hu Zhao Hu Zhao Xin Li Xin Li Shuqi Yang Shuqi Yang Tianjiao Liu Jun Zhan Jun Zhan Juan Zou Juan Zou Changsheng Lin Changsheng Lin Yalan Li Na Du Xue Xiao Xue Xiao |
| author_facet | Hu Zhao Hu Zhao Xin Li Xin Li Shuqi Yang Shuqi Yang Tianjiao Liu Jun Zhan Jun Zhan Juan Zou Juan Zou Changsheng Lin Changsheng Lin Yalan Li Na Du Xue Xiao Xue Xiao |
| author_sort | Hu Zhao |
| collection | DOAJ |
| description | IntroductionPlacenta accreta spectrum (PAS) may cause enormous and potentially life-threatening hemorrhage in the intrapartum and postpartum periods in emergency cesarean section. How to reduce the occurrence of emergency cesarean section in patients with severe PAS is the key to reducing the adverse outcomes of them. This study aimed to investigate the impact of emergency cesarean section on the perioperative outcomes of pregnant women with PAS and neonates, and also aimed to explore the risk factors of emergency cesarean section in pregnant women with PAS.Materials and methodsA retrospective investigation was conducted among 163 pregnant women with severe PAS. Of these, 72 were subjected to emergency cesarean sections. Data on the perioperative characteristics of the mothers and neonates were collected. Multivariable linear regression analysis was used to detect associations between maternal and perioperative characteristics and volume of intraoperative bleeding. Binary logical regression was used to analyze the association between maternal preoperative characteristics and emergency cesarean section. Linear regression analysis is used to analyze the relationship between gestational age and emergency cesarean section.ResultsThe risks of emergency cesarean section increase 98, 112, 124, and 62% when the pregnant women with PAS accompanied by GHD, ICP, more prior cesarean deliveries and more severe PAS type, respectively. Noteworthy, the risk of emergency cesarean section decreases 5% when pre-pregnancy BMI increases 1 kg/m2 (OR: 0.95; CI: 0.82, 0.98; p = 0.038). Moreover, there is no significant linear correlation between emergency cesarean section and gestational age.ConclusionGHD, ICP, multiple prior cesarean deliveries and severe PAS type may all increase the risk of emergency cesarean section for pregnant women with PAS, while high pre-pregnancy BMI may be a protective factor due to less activity level. For pregnant women with severe PAS accompanied by these high risk factors, more adequate maternal and fetal monitoring should be carried out in the third trimester to reduce the risk of emergency cesarean section. |
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| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-13T00:05:16Z |
| publishDate | 2023-07-01 |
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| spelling | doaj.art-e10b495121cf4807bcfc6226e9d79fa72023-07-13T05:10:32ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-07-011010.3389/fmed.2023.11955461195546Risk factors of emergency cesarean section in pregnant women with severe placenta accreta spectrum: a retrospective cohort studyHu Zhao0Hu Zhao1Xin Li2Xin Li3Shuqi Yang4Shuqi Yang5Tianjiao Liu6Jun Zhan7Jun Zhan8Juan Zou9Juan Zou10Changsheng Lin11Changsheng Lin12Yalan Li13Na Du14Xue Xiao15Xue Xiao16Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, ChinaChengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, ChinaDepartment of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, ChinaChengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, ChinaDepartment of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, ChinaDepartment of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, ChinaThe Fourth People’s Hospital of Chengdu, Psychosomatic Medical Center, Chengdu, ChinaThe Fourth People’s Hospital of Chengdu, Psychosomatic Medical Center, Chengdu, ChinaDepartment of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, ChinaIntroductionPlacenta accreta spectrum (PAS) may cause enormous and potentially life-threatening hemorrhage in the intrapartum and postpartum periods in emergency cesarean section. How to reduce the occurrence of emergency cesarean section in patients with severe PAS is the key to reducing the adverse outcomes of them. This study aimed to investigate the impact of emergency cesarean section on the perioperative outcomes of pregnant women with PAS and neonates, and also aimed to explore the risk factors of emergency cesarean section in pregnant women with PAS.Materials and methodsA retrospective investigation was conducted among 163 pregnant women with severe PAS. Of these, 72 were subjected to emergency cesarean sections. Data on the perioperative characteristics of the mothers and neonates were collected. Multivariable linear regression analysis was used to detect associations between maternal and perioperative characteristics and volume of intraoperative bleeding. Binary logical regression was used to analyze the association between maternal preoperative characteristics and emergency cesarean section. Linear regression analysis is used to analyze the relationship between gestational age and emergency cesarean section.ResultsThe risks of emergency cesarean section increase 98, 112, 124, and 62% when the pregnant women with PAS accompanied by GHD, ICP, more prior cesarean deliveries and more severe PAS type, respectively. Noteworthy, the risk of emergency cesarean section decreases 5% when pre-pregnancy BMI increases 1 kg/m2 (OR: 0.95; CI: 0.82, 0.98; p = 0.038). Moreover, there is no significant linear correlation between emergency cesarean section and gestational age.ConclusionGHD, ICP, multiple prior cesarean deliveries and severe PAS type may all increase the risk of emergency cesarean section for pregnant women with PAS, while high pre-pregnancy BMI may be a protective factor due to less activity level. For pregnant women with severe PAS accompanied by these high risk factors, more adequate maternal and fetal monitoring should be carried out in the third trimester to reduce the risk of emergency cesarean section.https://www.frontiersin.org/articles/10.3389/fmed.2023.1195546/fullplacenta accreta spectrumintraoperative bleedingemergency cesarean sectionpregnancyactivity level |
| spellingShingle | Hu Zhao Hu Zhao Xin Li Xin Li Shuqi Yang Shuqi Yang Tianjiao Liu Jun Zhan Jun Zhan Juan Zou Juan Zou Changsheng Lin Changsheng Lin Yalan Li Na Du Xue Xiao Xue Xiao Risk factors of emergency cesarean section in pregnant women with severe placenta accreta spectrum: a retrospective cohort study Frontiers in Medicine placenta accreta spectrum intraoperative bleeding emergency cesarean section pregnancy activity level |
| title | Risk factors of emergency cesarean section in pregnant women with severe placenta accreta spectrum: a retrospective cohort study |
| title_full | Risk factors of emergency cesarean section in pregnant women with severe placenta accreta spectrum: a retrospective cohort study |
| title_fullStr | Risk factors of emergency cesarean section in pregnant women with severe placenta accreta spectrum: a retrospective cohort study |
| title_full_unstemmed | Risk factors of emergency cesarean section in pregnant women with severe placenta accreta spectrum: a retrospective cohort study |
| title_short | Risk factors of emergency cesarean section in pregnant women with severe placenta accreta spectrum: a retrospective cohort study |
| title_sort | risk factors of emergency cesarean section in pregnant women with severe placenta accreta spectrum a retrospective cohort study |
| topic | placenta accreta spectrum intraoperative bleeding emergency cesarean section pregnancy activity level |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1195546/full |
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