Prediction of success of uterus‐preserving management in women with placenta accreta spectrum (CON‐PAS score): A multicenter international study
Makaleler > Tam Makale · 2020
Yazarlar: Sherif A Shazly, İsmet HORTU, Jin-Chung Shih, Rauf Melekoglu, Shangrong Fan, Farhat Ul Ain Ahmed, Erbil Karaman, Ildar Fatkullin, Pedro V Pinto, Setyorini Irianti, Joel Noutakdie Tochie, Amr S Abdelbadie, Mohamed A Salah, Hossam Aldein S Abd Elazeem, Mahmoud M Saad, Ahmet M Ergenoglu, Ahmet Özgür YENİEL, Sermet SAĞOL, Ismail M Itil, Jessica Kang, Kuan-Ying Huang, Ercan Yilmaz, Yiheng Liang, Hijab Aziz, Tayyiba Akhter, Afshan Ambreen, Çağrı Ateş, Yasemin Karaman, Albir Khasanov, Larisa Fatkullina, Nariman Akhmadeev, Adelina Vatanina, Ana Paula Machado, Nuno Montenegro, Jusuf S Effendi, Dodi Suardi, Ahmad Y Pramatirta, Muhamad A Aziz, Amilia Siddiq, Ingrid Ofakem, Julius Sama Dohbit, Mohamed S Fahmy, Mohamed A Anan
International Journal of Gynecology & Obstetrics, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Wos, 2020, cilt 154, ss 304-311
DOI: 10.1002/ijgo.13518
Özet
OBJECTIVE: To create a model for prediction of success of uterine-preserving procedures in women with placenta accreta spectrum (PAS). METHODS: PAS-ID is a multicenter study that included 11 centers from 9 countries. Women with PAS, who were managed between January 1, 2010 and December 31, 2019, were retrospectively included. Data were split into model development and validation cohorts, and a prediction model was created using logistic regression. Main outcome was success of uterine preservation. RESULTS: Out of 797 women with PAS, 587 were eligible. Uterus-preserving procedures were successful in 469 patients (79.9%). Number of previous cesarean sections (CS) was inversely associated with management success (adjusted odds ratio [aOR] 0.02, 95% confidence interval [CI] 0.001-3.63 with five previous CS). Other variables were complete placental invasion (aOR 0.14, 95% CI 0.05-0.43), type of CS incision (aOR 0.04, 95% CI 0.01-0.25 for classical incision), compression sutures (aOR 2.48, 95% CI 1.00-6.16), accreta type (aOR 3.76, 95% CI 1.13-12.53), incising away from placenta (aOR 5.09, 95% CI 1.52-16.97), and uterine resection (aOR 102.57, 95% CI 3.97-2652.74). CONCLUSION: The present study provides a prediction model for success of uterine preservation, which may assist preoperative and intraoperative decisions, and promote incorporation of uterine preservation procedures in comprehensive PAS protocols.