Comparison of conservative and radical surgery in the management of placenta previa percreta

Abstract

Objective We aimed to compare the uterine sparing (US) surgery and hysterectomy for placenta previa percreta (PPP) management. Methods Data from PPP patients with anterior invasion who underwent US surgery and caesarean hysterectomy were retrospectively analyzed. The clinical and surgical outcomes of patients with PPP were compared according to the type of surgery. Results The mean intraoperative blood loss was lower in US surgery group than in caesarean hysterectomy group (1227.78±204.80 ml vs 1442.22±125.68 ml; p=0.017). The hemoglobin drop was also significantly lower in the patients with US surgery (1.87±0.68 g/dl vs 2.88±1.04 g/dl; p=0.026). Moreover, the mean total transfusion rate was also significantly lower in the patients with US surgery (1.33±0.87 U vs 2.33±0.71 U; p=0.016). Conclusion Uterine sparing surgery reduces intraoperative blood loss and transfusion rate in PPP patients with anterior placental invasion compared to hysterectomy. The temporary blockage of bilateral uterine and uteroovarian arteries with Satinsky clamps may potentially contribute to the success of US surgery.