International journal of women's health · 2025
Comparison of Maternal Outcomes Between Cesarean Hysterectomy and Wedge Resection in Pregnant Women with Figo Grade 2 Placenta Accreta Spectrum.
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Roseli Anastasya, Bayuaji Hartanto, Aziz Muhammad Alamsyah
Аннотация
OBJECTIVE: To compare maternal outcomes between cesarean hysterectomy and wedge resection in pregnant women diagnosed with FIGO grade 2 placenta accrete spectrum (PAS).
METHODS: This retrospective cohort study with a cross-sectional design included pregnant women diagnosed with FIGO grade 2 PAS by ultrasonography who underwent either cesarean hysterectomy or wedge resection at Hasan Sadikin General Hospital between 2022-2025. The maternal outcomes analyzed included the amount of bleeding, duration of surgery, and the need for transfusion. Statistical analyses were conducted using the chi-square test (p <0.05).
RESULTS: A total of 83 patients were included, 49 patients underwent cesarean hysterectomy and 34 wedge resection. Based on the characteristics of the study participants, no significant differences were found in age or parity between the groups. Patients in the wedge resection group had significantly shorter operative duration and lower amount of bleeding compared with the hysterectomy group (p<0.05). Transfusion requirements of <4 units were comparable (63% vs 62%, x2=0.019, p=0.88).
CONCLUSION: Both WR and CH are viable surgical options for FIGO grade 2 PAS. The increasing incidence of PAS is associated with previous cesarean section and multiparity. WR was associated with a shorter duration of surgery than CH. However, differences in blood loss and transfusion requirements were not statistically significant. These findings highlight the importance of individualized surgical planning and the potential role of postoperative management in optimizing maternal outcomes.
METHODS: This retrospective cohort study with a cross-sectional design included pregnant women diagnosed with FIGO grade 2 PAS by ultrasonography who underwent either cesarean hysterectomy or wedge resection at Hasan Sadikin General Hospital between 2022-2025. The maternal outcomes analyzed included the amount of bleeding, duration of surgery, and the need for transfusion. Statistical analyses were conducted using the chi-square test (p <0.05).
RESULTS: A total of 83 patients were included, 49 patients underwent cesarean hysterectomy and 34 wedge resection. Based on the characteristics of the study participants, no significant differences were found in age or parity between the groups. Patients in the wedge resection group had significantly shorter operative duration and lower amount of bleeding compared with the hysterectomy group (p<0.05). Transfusion requirements of <4 units were comparable (63% vs 62%, x2=0.019, p=0.88).
CONCLUSION: Both WR and CH are viable surgical options for FIGO grade 2 PAS. The increasing incidence of PAS is associated with previous cesarean section and multiparity. WR was associated with a shorter duration of surgery than CH. However, differences in blood loss and transfusion requirements were not statistically significant. These findings highlight the importance of individualized surgical planning and the potential role of postoperative management in optimizing maternal outcomes.