BMC pregnancy and childbirth · 2025
The effect of preoperative intravenous iron administration on patient outcomes in the spectrum of placenta accreta: a retrospective case-control study.
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Zeki Nessar Ahmet, Dal Yusuf, Karagün Şebnem, Çevikoğlu Kıllı Mürşide, Yıldız Hamza, Durukan Hüseyin, Işıl Adıgüzel Fikriye, Coşkun Ayhan
Аннотация
BACKGROUND: We aimed to investigate the effect of preoperative intravenous (IV) iron administration on maternal outcomes in patients with placenta acreata spectrum (PAS).
METHODS: The study group comprised 72 patients diagnosed with PAS who underwent surgery and received IV iron preoperatively. The control group consisted of 71 patients who underwent the same diagnosis but did not receive IV iron. We recorded and compared the groups' demographic and obstetric findings, laboratory results, preoperative and postoperative blood product requirements, operation duration, characteristics, hospital stay, and neonatal outcomes.
RESULTS: We compared the IV iron group's data to that of the control group and found that the study group needed significantly less erythrocyte suspension (ES) transfusions during surgery (32 (44.4%)) and after surgery (56 (77.8%)) than the control group (p < 0.05). Total ES transfusion requirement (1.38 ± 0.896) and total fresh frozen plasma (FFP) transfusion requirement (0.55 ± 0.785) in the study group were significantly less than the control group (p < 0.05). Postoperative hospital stay (hours) was also significantly shorter in the study group (56.34 ± 15.06) than in the control group (83.18 ± 21.64) (p < 0.05). The use of Bakri balloon tamponade was significantly higher in the control group (38 (52.8%)) than in the study group (12 (16.9%)) (p = 0.00), and the number of bilateral hypogastric artery ligations and total abdominal hysterectomy was significantly lower in the study group (13 (18.1)/2.8) than in the control group (53 (74.6)/19 (26.8)) (p < 0.05). There was no statistically significant difference between the groups in terms of the use of compression sutures, lower uterine segment resection, or adjacent organ damage (p > 0.05).
CONCLUSIONS: Preoperative IV iron administration positively affects intraoperative bleeding, operative time, blood product requirement, peripartum hysterectomy requirement, and hospital stay.
METHODS: The study group comprised 72 patients diagnosed with PAS who underwent surgery and received IV iron preoperatively. The control group consisted of 71 patients who underwent the same diagnosis but did not receive IV iron. We recorded and compared the groups' demographic and obstetric findings, laboratory results, preoperative and postoperative blood product requirements, operation duration, characteristics, hospital stay, and neonatal outcomes.
RESULTS: We compared the IV iron group's data to that of the control group and found that the study group needed significantly less erythrocyte suspension (ES) transfusions during surgery (32 (44.4%)) and after surgery (56 (77.8%)) than the control group (p < 0.05). Total ES transfusion requirement (1.38 ± 0.896) and total fresh frozen plasma (FFP) transfusion requirement (0.55 ± 0.785) in the study group were significantly less than the control group (p < 0.05). Postoperative hospital stay (hours) was also significantly shorter in the study group (56.34 ± 15.06) than in the control group (83.18 ± 21.64) (p < 0.05). The use of Bakri balloon tamponade was significantly higher in the control group (38 (52.8%)) than in the study group (12 (16.9%)) (p = 0.00), and the number of bilateral hypogastric artery ligations and total abdominal hysterectomy was significantly lower in the study group (13 (18.1)/2.8) than in the control group (53 (74.6)/19 (26.8)) (p < 0.05). There was no statistically significant difference between the groups in terms of the use of compression sutures, lower uterine segment resection, or adjacent organ damage (p > 0.05).
CONCLUSIONS: Preoperative IV iron administration positively affects intraoperative bleeding, operative time, blood product requirement, peripartum hysterectomy requirement, and hospital stay.