ARTICLE
TITLE

Placenta Accreta Spectrum Disorders: A. Chohan Continuous Squeezing Suture (ACCSS) for Controlling Haemorrhage from the Lower Uterine Segment at Caesarean Section

SUMMARY

Objectives: To describe the simplicity, efficacy and safety of A. Chohan Continuous Squeezing Suture (ACCSS) for controlling haemorrhage from the lower uterine segment at caesarean section for placenta praevia and accreta spectrum disorders.Methods: This prospective study was conducted on 47 patients with placenta praevia and accreta spectrum disorders from February 2019 to May 2022 in two teaching hospitals of Lahore and ACCSS was applied. The outcome measures were peripartum hysterectomy procedure time, estimated blood loss, number of blood transfusions, duration of stay in the hospital, bladder trauma, uterine necrosis, pelvic abscess formation, secondary postpartum haemorrhage and maternal mortality. Descriptive statistics were calculated by using SPSS version 21.Results: Out of 47 patients, 7 (15%) had placenta creta, 29 (61.7%) increta, 11 (23.3%) percreta (grade 3a), and 36 (76.6%) central anterior dominant placenta. Peripartum hysterectomy was prevented in 97.8% of patients. ACCSS procedure time was 5-10 minutes (87.2%), with mean blood loss 2500±485 ml, mean blood transfusion 1.85±1.02 units and mean hospital stay of 3.3±0.84 days. One patient had bladder trauma. There was no case of uterine necrosis, pelvic abscess formation, secondary postpartum haemorrhage or maternal mortality.Conclusion: ACCSS appears to be a simple, effective and safe treatment option for placenta praevia and accreta spectrum disorders, as an alternative to hysterectomy.Registration: ClinicalTrial.gov NCT04660578, NCT05070689.doi: https://doi.org/10.12669/pjms.39.1.6990How to cite this: Chohan MA, Butt F, Imran M, Zahra S, Chohan MA. Placenta Accreta Spectrum Disorders: A. Chohan Continuous Squeezing Suture (ACCSS) for Controlling Haemorrhage from the Lower Uterine Segment at Caesarean Section. Pak J Med Sci. 2023;39(1):166-171.    doi: https://doi.org/10.12669/pjms.39.1.6990This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

 Articles related

Margarida Cal,Carla Nunes,Nuno Clode,Diogo Ayres-de-Campos    

Introduction: Placenta accreta spectrum disorders are among the leading causes of maternal morbidity and mortality and their prevalence is likely to increase in the future. The risk of placenta accreta spectrum disorders is highest in cases of placenta p... see more


Zhuanji Fang, Huale Zhang, Shuisen Zheng, Lingling Weng, Jianying Yan    

Objectives: To investigate the indications of obstetric emergency hysterectomy and analyze the clinical effects of subtotal hysterectomy and total hysterectomy.Methods: We included 247 hospitalized women who had undergone abdominal hysterectomy due to ob... see more


Widiana Ferriastuti,Qonita - -    

There has been an increased incidence of placenta accreta in recent decades, which is associated with an increase in cesarean delivery. A woman aged 39 years GIVP1111 at 8 months of gestation was a breech location with antepartum bleeding et. causa plac... see more

Revista: Health Notions

PN Nana,L Morfaw,JN Fomulu,S Fomulu,S Temkou,C Wandji,RIJ Leke    

Placenta percreta is a rare complication of pregnancy and delivery and carries grievous consequences to the mother. It occurs mostly in the third trimester and presents with severe postpartum haemorrhage and placenta retention. Several types (accreta, in... see more


Yuktiana Kharisma,Hasrayati Agustina,Sri Suryanti,Birgitta Maria Dewayani,Bethy Suryawati Hernowo    

Low birth weight (LBW) babies are closely related to infant morbidity, stunted growth and cognitive development, and chronic diseases. Placenta accreta spectrum (PAS) is a condition that complicates pregnancy and is closely related to low birth weight. O... see more