Poster Session 2
Yonatan Dror, MD (he/him/his)
Chaim Sheba Medical Center, Tel‑Hashomer, Ramat‑Gan, Israel
Chaim Sheba Medical Center, Tel‑Hashomer, Ramat‑Gan, Israel, HaMerkaz, Israel
Elias Castel, MD
Sheba Medical Center
Ramat Gan, HaMerkaz, Israel
Raanan Meyer, MD
Cedars Sinai Medical Center
Los Angeles, California, United States
Lior Fridrich, MD
Sheba Medical Center
Ramat Gan, HaMerkaz, Israel
Nizan Mor, MD
Sheba Medical Center
Ramat Gan, HaMerkaz, Israel
Aviran Ohayon, MD
Sheba Medical Center
Ramat Gan, HaMerkaz, Israel
Michal Axelrod, MD, MPH (she/her/hers)
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel HaShomer
Ramat Gan, HaMerkaz, Israel
Alina Weissmann-Brenner, MD
Sheba Medical Center
Ramat Gan, HaMerkaz, Israel
Gabriel Levin, MD
McGill University
Montreal, Quebec, Canada
Shlomi Toussia Cohen, MD (he/him/his)
Sheba Medical Center
Ramat Gan, HaMerkaz, Israel
A retrospective cohort study conducted at a single tertiary center between 03/2011 and 01/2022. Women with PAS who underwent uterine conserving cesarean delivery were included. Women with scheduled cesarean hysterectomy were excluded. A composite of adverse maternal outcome was defined as the occurrence of at least one of the following: bladder injury, ureteral injury, bowel injury, ≥6 units of blood transfusion, p</span>ostoperative fever, unplanned cesarean hysterectomy, relaparotomy, intensive care unit admission and hospital readmission. We compared patients with and without the composite adverse outcome. Multivariable regression analysis was used to identify factors associated with the composite of adverse outcome. 238 women with PAS were included in the study group, 70 had composite adverse maternal outcome and 168 did not. The maternal adverse outcome group had earlier gestational age at delivery (median 360/7 vs. 363/7 weeks), higher preoperative uterine rupture rates (6.2% vs. 0.6%), longer cesarean delivery duration (median 118.5 vs. 68.0 minutes), more drainage placement (72.5% vs. 23.8%) and higher estimated blood loss (median 2500.0 vs. 1200.0 ml). In multivariable logistic regression analysis, earlier gestational age at delivery, and the sonographic findings of lacunae, bridging vessels and loss of clear zone were independently associated with the composite adverse maternal outcome.
Results:
Conclusion: Among women undergoing uterine conserving cesarean delivery for PAS, an earlier gestational age at delivery, and three sonographic findings, are associated with adverse maternal outcomes.