Table 3.14: Uterine treatment methods
Uterine treatment
Quantity (n) | Ratio (%) | |
Preservation of the uterus | 22 | 23.7 |
Hysterectomy | 71 | 76.3 |
Total | 93 | 100 |
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Comment:
- Hysterectomy rate is 76.3%.
- The rate of uterine preservation is 23.7%.
Level 3
100%
Level 2
91.4%
8.6%
Level 1
11.1%
88.9%
0
20
40
Hysterectomy
60
80
100
120
Preservation of the uterus
Figure 3.3: Degree of placenta accreta and treatment methods
Comment:
- In the treatment of grade 1 RCRL, 88.9% preserved the uterus and 11.1% had hysterectomy.
- In the treatment of grade 2 RCRL, 91.4% were hysterectomy and 8.6% were uterine preservation.
- In the treatment of grade 3 RCRL, 100% hysterectomy is performed.
3.2.4. Surgery time
Table 3.15: Surgical time
Surgery time
Quantity (n) | Ratio (%) | |
Under 90 minutes | 35 | 37.6 |
From 91 to 120 minutes | 35 | 37.6 |
Over 120 minutes | 23 | 24.7 |
Total | 93 | 100 |
Comment:
- Surgery time under 90 minutes and from 90 to 120 minutes have equal proportions and account for 37.6%.
- Surgery time over 120 minutes has a lower rate and accounts for 24.7%.
Table 3.16: RCRL level and surgery time
Surgery time
Level | Total | p | |||||||
Level 1 | Level 2 | Level 3 | |||||||
n | % | n | % | n | % | n | % | ||
Under 90 minutes | 11 | 61.1 | 24 | 34.3 | 0 | 0.0 | 35 | 37.6 | < 0.05 |
From 91 to 120 minutes | 6 | 33.3 | 26 | 37.1 | 3 | 60.0 | 35 | 37.6 | |
Over 120 minutes | 1 | 5.6 | 20 | 28.6 | 2 | 40.0 | 23 | 24.7 | |
Total | 18 | 100 | 70 | 100 | 5 | 100 | 93 | 100 | |
Comment:
- RCRL grade 1 had a surgical time mostly under 90 minutes with a rate of 61.1%, 33.3% had a surgical time from 91 to 120 minutes and 5.6% had a surgical time over 120 minutes.
- RCRL grade 2 with surgical time under 90 minutes accounted for 34.3% and surgical time from 91 to 120 minutes and over 120 minutes accounted for 37.1% and 28.6%, respectively.
- RCRL grade 3 has a surgical time of 90 to 120 minutes accounting for 60% and over 120 minutes accounting for 40%.
- Surgery time under 90 minutes was most common in RCRL grade 1 with 61.1% and there were no cases of RCRL grade 3 with surgery time under 90 minutes.
- Surgical time from 90 to 120 minutes is most common in grade 3 RCRL with 60%.
- Surgery time over 120 minutes is most common in RCRL grade 3 with a rate of 40%
Table 3.17: Relationship between RCRL level and surgery time
Level
RCRL
n | Medium | GTLN | GTNN | P | |
Level 1 | 18 | 72.8 29 | 150 | 35 | < 0.05 |
Level 2 | 70 | 101.9 39.0 | 225 | 40 | |
Level 3 | 5 | 113 37.0 | 175 | 90 | |
Total | 93 | 97.0 38.8 | 35 | 225 |
Comment:
- The average surgical time was 97.0 ± 38.8 minutes, the shortest surgical time was 35 minutes, the longest was 225 minutes.
- For RCRL grade 1, the average surgical time was 72.8 ± 29 minutes, the shortest surgical time was 35 minutes, the longest surgical time was 150 minutes.
- For RCRL grade 2, the average surgical time was 101.9 ± 39.0 minutes, the shortest surgical time was 40 minutes, the longest surgical time was 225 minutes.
- For grade 3 RCRL, the average surgical time was 113 ± 37.0 minutes, the shortest surgical time was 90 minutes, the longest surgical time was 175 minutes.
3.2.5. Complications for the mother
Table 3.18: Complications of surgery
Complications of surgery
Quantity (n) | Ratio (%) | |
Bladder rupture | 13 | 14.0 |
Urethral injury | 2 | 2.2 |
Postpartum infection | 4 | 4.3 |
Total | 19 | 20.4 |
Comment:
- The study recorded 19 cases with complications due to RCRL, accounting for 20.4%.
- Bladder rupture accounts for 14%.
- Postpartum infection accounts for 4.3%.
- Urethral injury accounts for the lowest rate of 2.2%.
Table 3.19: Blood loss and blood transfusion during surgery (ml)
Blood volume (ml)
Quantity | Medium | GTNN | GTLN | |
Lost | 93 | 1727.4 1194.0 | 500 | 8000 |
Be transmitted | 89 | 1231 731.3 | 350 | 3550 |
Comment:
- 89/93 patients received blood transfusion after surgery.
- Average blood loss was 1727.4 ± 1194.0 ml.
- The average amount of blood transfused was 1231 ± 731.3 ml.
- The minimum amount of blood loss is 500 ml, the maximum amount of blood loss is 8000 ml.
- The minimum amount of blood transfused is 350 ml, the maximum amount of blood transfused is 3550 ml.
Table 3.20: Relationship between blood loss and placenta accreta level
RCRL level
n | Medium | GTLN | GTNN | p | |
Level 1 | 18 | 1233.3 ± 705.4 | 3500 | 500 | > 0.05 |
Level 2 | 70 | 1903.6 ± 1276.4 | 8000 | 500 | |
Level 3 | 5 | 1040.0 ± 577.1 | 2000 | 500 | |
Total | 93 | 1727.4 ± 1193.9 | 8000 | 500 |
Comment:
- The average blood loss in RCRL level 1 was 1233.3 ± 705.4 ml, the least blood loss was 500 ml, the most was 3500 ml.
- The average blood loss in RCRL level 2 was 1903.6 ± 1276.4 ml, the least blood loss was 500 ml, the most was 8000 ml.
- The average blood loss in RCRL grade 3 was 1040.0 ± 577.1 ml, the least blood loss was 500 ml, the most was 2000 ml.
- The difference is not statistically significant with p > 0.05.
Table 3.21: Relationship between blood transfusion volume and RCRL level
RCRL level
n | Medium | GTLN | GTNN | p | |
Level 1 | 17 | 926.5 ± 552.6 | 2450 | 350 | > 0.05 |
Level 2 | 68 | 1308.1 ± 768.6 | 3550 | 320 | |
Level 3 | 4 | 1225.0 ± 451.8 | 1750 | 700 | |
Total | 89 | 1231.5 ± 731.3 | 3550 | 350 |
Comment:
- The average amount of blood transfused in RCRL level 1 was 926.5 ± 552.6 ml, the minimum amount of blood transfused was 500 ml, the maximum was 2450 ml.
- The average blood loss in RCRL level 2 was 1308.1 ± 768.6 ml, the minimum amount of blood transfused was 320 ml, the maximum was 3550 ml.
- The average blood loss in RCRL grade 3 was 1225.0 ± 451.8 ml, the minimum amount of blood transfused was 700 ml, the maximum was 1750 ml.
- The difference is not statistically significant with p > 0.05.
3.2.6. Complications for children
Table 3.22: Gestational age at surgery
Gestational age
Quantity (n) | Ratio (%) | |
< 34 weeks | 7 | 7.5 |
34 - 37 weeks | 60 | 64.5 |
>37 weeks | 26 | 28.0 |
Total | 93 | 100 |
Comment:
- The most common gestational age at birth is 34 - 37 weeks with 64.5%.
- The second most common gestational age at birth is gestational age over 37 weeks, accounting for 28%.
- The gestational age accounts for the least percentage of less than 34 weeks with a rate of 7.5%.
Table 3.23: Relationship between gestational age at birth and degree of placenta accreta
Gestational age
RCRL degree
< 34 weeks | 34 - 37 weeks | > 37 weeks | Total | P | ||||
n | (%) | n | (%) | n | (%) | n | (%) | > 0.05 |
Level 1 | 1 | 14.3 | 12 | 20.0 | 5 | 19.2 | 18 | 19.4 |
Level 2 | 5 | 71.4 | 45 | 75.0 | 20 | 76.9 | 70 | 75.3 |
Level 3 | 1 | 14.3 | 3 | 5.0 | 1 | 3.9 | 5 | 5.4 |
Total | 7 | 100 | 60 | 100 | 26 | 100 | 93 | 100 |
Comment:
- RCRL level 2 has the highest rate, followed by RCRL level 1 and RCRL level 3 has the lowest rate, this result occurs in all gestational age groups.
- RCRL level 1 in the gestational age group from 34 - 37 weeks accounted for 20%, in the gestational age group over 37 weeks accounted for 19.2%, in the gestational age group under 34 weeks accounted for 14.3%.
- The level of RCRL level 2 in the gestational age group over 37 weeks was 76.9%; higher than the gestational age group under 34 weeks (71.4%) and the gestational age group from 34 to 37 weeks (75%).
- RCRL level 3 is most common in the gestational age group under 34 weeks.
- The difference is not statistically significant with p > 0.05.
Table 3.24: Relationship between gestational age at surgery and timing of surgery
Time of surgery
n | Medium | GTLN | GTNN | p | |
Emergency surgery | 11 | 34.0 ± 2.8 | 37 | 30 | < 0.05 |
Active surgery | 82 | 37.0 ± 1.9 | 41 | 30 | |
Total | 93 | 36.7 ± 2.2 | 41 | 30 |
Comment:
- The average gestational age at surgery was 36.7 ± 2.2 weeks.
- The average gestational age at the time of emergency cesarean section was 34.0 ± 2.8 weeks, the youngest gestational age was 30 weeks, the oldest was 37 weeks.
- The average gestational age at the time of elective cesarean section was 37.0 ± 1.9 weeks.
Table 3.25: Relationship between gestational age at birth and treatment methods
Gestational age
Treatment
28 - 34 weeks | 34 - 37 weeks | > 37 weeks | Total | |||||
n | (%) | n | (%) | n | (%) | n | (%) | |
Preservation of the uterus | 2 | 28.6 | 13 | 21.7 | 7 | 26.9 | 22 | 23.7 |
Hysterectomy | 5 | 71.4 | 47 | 78.3 | 19 | 73.1 | 71 | 76.3 |
Total | 7 | 100 | 60 | 100 | 26 | 100 | 93 | 100 |
(p> 0.05)
Comment:
- Hysterectomy is more common than uterine preservation in all gestational age groups.
- Uterine preservation has the highest rate in the gestational age group under 34 weeks.
- Hysterectomy has the highest rate in the gestational age group from 34 to 47 weeks.
- The difference is not statistically significant with p > 0.05 .