Maternal and neonatal outcomes in placenta accreta spectrum: Influence of antenatal diagnosis and surgical strategy

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dc.contributor.authorOrujova, Lumayat
dc.contributor.authorMelekoglu, Rauf
dc.contributor.authorYilmaz, Ercan
dc.contributor.authorOzdemir, Halis
dc.contributor.authorYasar, Seyma
dc.date.accessioned2026-04-04T13:30:49Z
dc.date.available2026-04-04T13:30:49Z
dc.date.issued2026
dc.departmentİnönü Üniversitesi
dc.description.abstractObjective This study aimed to evaluate the influence of antenatal diagnosis and surgical management strategies on maternal and neonatal outcomes in placenta accreta spectrum (PAS) disorders, emphasizing risk factors, timing of delivery, and operative approaches. Materials and Methods A retrospective cohort analysis was conducted on 210 women with histopathologically confirmed PAS managed at & Idot;n & ouml;n & uuml; University Faculty of Medicine between January 2014 and March 2024. Demographic data, antenatal findings, delivery type, and surgical details were compared between elective and emergency procedures, as well as between uterus-preserving surgery and peripartum hysterectomy. Uterus-preserving surgery refers to conservative techniques that aim to avoid peripartum hysterectomy while controlling hemorrhage. Results Of the total cohort, 66.7% underwent elective surgery, whereas 33.3% required emergency intervention. Emergency deliveries occurred earlier (mean 32.1 vs. 36.0 weeks, p<0.001) and were associated with higher blood loss (799 vs. 511 mL, p<0.001), increased perinatal mortality (20% vs. 1.4%, p<0.001), and greater neonatal morbidity, mainly respiratory distress syndrome (47% vs. 14%, p<0.001). Hysterectomy was required in 45.2% of patients, primarily with placenta percreta (60% vs. 23.5%, p<0.001). Anterior placental location (89.5%) strongly correlated with complete invasion (77.7%) and bladder involvement (27.7%, p=0.038). Bladder injuries were more common in elective cases, while ureteral injuries occurred more often in emergencies (p=0.024). Preoperative hematocrit independently predicted hysterectomy risk (odds ratio: 1.092, p=0.034). Conclusion Antenatal diagnosis and well-planned elective management significantly improve maternal and neonatal outcomes in PAS. Individualized surgical planning based on invasion depth and maternal condition remains essential to reduce morbidity and mortality.
dc.identifier.doi10.4274/tjod.galenos.2025.28235
dc.identifier.endpage33
dc.identifier.issn2149-9322
dc.identifier.issn2149-9330
dc.identifier.issue1
dc.identifier.pmid41568602
dc.identifier.scopus2-s2.0-105032711041
dc.identifier.scopusqualityQ3
dc.identifier.startpage8
dc.identifier.urihttps://doi.org/10.4274/tjod.galenos.2025.28235
dc.identifier.urihttps://hdl.handle.net/11616/108386
dc.identifier.volume23
dc.identifier.wosWOS:001710391600001
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherGalenos Publ House
dc.relation.ispartofTurkish Journal of Obstetrics and Gynecology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250329
dc.subjectIntraoperative complications
dc.subjectplacenta accreta
dc.subjectpregnancy outcome
dc.subjectprenatal diagnosis
dc.titleMaternal and neonatal outcomes in placenta accreta spectrum: Influence of antenatal diagnosis and surgical strategy
dc.typeArticle

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