Clinical analysis of uterus preservation for placenta previa complicated with placenta accreta spectrum by pre-freeing the bladder combined with fishnet-like reconstruction of the lower uterine segment

Methods

This study reviewed the clinical outcomes of 104 patients who underwent cesarean section in our hospital due to scarred uterus with placenta previa and placenta accreta spectrum from November 1st, 2019 to December 31st, 2022. The 104 patients were divided into the group of intraoperative blood loss ≥2000ml with 20 cases and the group of intraoperative blood loss <2000ml with 84 cases. We analyzed the risk factors of intraoperative blood loss ≥2000ml in this surgical procedure through univariate analysis and multivariate logistic regression analysis.Results Of the 104 pregnant women, the median gestational age of delivery was 35+2 (33+5~36+2) weeks , the median intraoperative blood loss was 1200 (800~1575)ml, the median volume of autologous blood reinfusion was 450 (250-800)ml, the median allogeneic suspended red blood cell infusion was 2.0 (1.5~3.4)U, 103 cases (99.0%) successfully preserved the uterus, 1 case underwent cesarean hysterectomy, 7 cases (6.7%) experienced surgical complications, there was no maternal death.