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Prediction of success of uterus‐preserving management in women with placenta accreta spectrum (CON‐PAS score): A multicenter international study
Author(s) -
Shazly Sherif A.,
Hortu Ismet,
Shih JinChung,
Melekoglu Rauf,
Fan Shangrong,
Ahmed Farhat ul Ain,
Karaman Erbil,
Fatkullin Ildar,
Pinto Pedro V.,
Irianti Setyorini,
Tochie Joel Noutakdie,
Abdelbadie Amr S.,
Salah Mohamed A.,
Elazeem Hossam Aldein S. Abd,
Saad Mahmoud M.,
Ergenoglu Ahmet M.,
Yeniel Ahmet O.,
Sagol Sermet,
Itil Ismail M.,
Kang Jessica,
Huang KuanYing,
Yilmaz Ercan,
Liang Yiheng,
Aziz Hijab,
Akhter Tayyiba,
Ambreen Afshan,
Ateş Çağrı,
Karaman Yasemin,
Khasanov Albir,
Fatkullina Larisa,
Akhmadeev Nariman,
Vatanina Adelina,
Machado Ana Paula,
Montenegro Nuno,
Effendi Jusuf S.,
Suardi Dodi,
Pramatirta Ahmad Y.,
Aziz Muhamad A.,
Siddiq Amilia,
Ofakem Ingrid,
Dohbit Julius Sama,
Fahmy Mohamed S.,
Anan Mohamed A.
Publication year - 2021
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13518
Subject(s) - medicine , placenta accreta , odds ratio , logistic regression , confidence interval , obstetrics , uterus , multicenter study , gynecology , placenta , pregnancy , surgery , fetus , genetics , biology , randomized controlled trial
Abstract Objective To create a model for prediction of success of uterine‐preserving procedures in women with placenta accreta spectrum (PAS). Methods PAS‐ID is a multicenter study that included 11 centers from 9 countries. Women with PAS, who were managed between January 1, 2010 and December 31, 2019, were retrospectively included. Data were split into model development and validation cohorts, and a prediction model was created using logistic regression. Main outcome was success of uterine preservation. Results Out of 797 women with PAS, 587 were eligible. Uterus‐preserving procedures were successful in 469 patients (79.9%). Number of previous cesarean sections (CS) was inversely associated with management success (adjusted odds ratio [aOR] 0.02, 95% confidence interval [CI] 0.001–3.63 with five previous CS). Other variables were complete placental invasion (aOR 0.14, 95% CI 0.05–0.43), type of CS incision (aOR 0.04, 95% CI 0.01–0.25 for classical incision), compression sutures (aOR 2.48, 95% CI 1.00–6.16), accreta type (aOR 3.76, 95% CI 1.13–12.53), incising away from placenta (aOR 5.09, 95% CI 1.52–16.97), and uterine resection (aOR 102.57, 95% CI 3.97–2652.74). Conclusion The present study provides a prediction model for success of uterine preservation, which may assist preoperative and intraoperative decisions, and promote incorporation of uterine preservation procedures in comprehensive PAS protocols.