Transverse Uterine Fundal Incision During Cesarean Hysterectomy for Women with Placenta Accreta Spectrum Disorder
Keywords:
Transverse uterine fundal incision, classical uterine incision, placenta accrete spectrumAbstract
Background and Objective: Transverse uterine fundal (TUF) incision, a transverse incision made in the uterine fundus, has been proposed for women with placenta accreta spectrum (PAS) disorder. This study assessed the feasibility of TUF incision compared with classical incision (a midline vertical uterine incision).
Methods: This retrospective cohort study reviewed medical records of pregnant women with PAS disorder undergoing cesarean hysterectomy during January 2015 to December 2021 at Faculty of Medicine, Khon Kaen University. Abstract data included baseline characteristics (i.e. PAS grading, types of uterine incision, hysterectomy technique) and maternal and neonatal outcomes.
Results: Thirty-two and fifteen women underwent TUF incision and classical incision, respectively. There was a higher proportion of women in TUF group who had grade 3 PAS than those in classical incision group (75.0% versus 66.7%, respectively). Compared to women undergoing classical incision, although women undergoing TUF incision carried longer operative time (215 min versus 160 min), the rate of massive transfusion were lower (28.1% versus 46.7%). The rate of admission to neonatal intensive care unit were comparable between the two groups. Neonates born to mothers who underwent TUF incision were less likely to experience birth asphyxia (15.6% versus 26.7%).
Conclusion: TUF incision performed during cesarean hysterectomy for PAS disorders appeared to be clinically feasible as it did not increase adverse perioperative outcomes.
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