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Management of placenta accreta spectrum disorders in COVID 19 patients

Rozi Aditya Aryananda1, Albaro José Nieto-Calvache2, Nareswari Imanadha Cininta1

  • 1Dr. Soetomo Academic General Hospital, Universitas Airlangga, Surabaya, Indonesia.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|November 24, 2021
PubMed

Insights

COVID-19 infection during surgery for placenta accreta spectrum (PAS) increases complication risks. PAS teams need updated protocols to manage these obstetric emergencies safely during pandemics.

Area of Science:

  • Obstetrics and Gynecology
  • Infectious Diseases
  • Public Health

Background:

  • The COVID-19 pandemic strained global maternal healthcare resources.
  • Placenta accreta spectrum (PAS) is a severe obstetric condition requiring significant medical resources.
  • Managing PAS during a pandemic presents unique challenges for healthcare teams.

Purpose of the Study:

  • To evaluate clinical outcomes for PAS patients during the COVID-19 pandemic.
  • To analyze the impact of the pandemic on PAS team functionality.
  • To compare outcomes between PAS patients with and without SARS-CoV-2 infection during surgery.

Main Methods:

  • A descriptive, retrospective study was conducted in two reference hospitals in low- to middle-income countries.
  • Data were collected from January 2020 to March 2021.
  • Patients were divided into two groups: those with SARS-CoV-2 infection during PAS surgery (Group 1) and those without (Group 2).

Main Results:

  • 145 patients undergoing PAS surgery were included.
  • Group 1 (11 cases) had longer operative times (250 min vs. 180 min) and significantly higher complication rates (54.5% vs. 17.9%) compared to Group 2.
  • Intraoperative and postoperative complications were more frequent in patients with active SARS-CoV-2 infection.

Conclusions:

  • Patients with placenta accreta spectrum undergoing surgery during acute SARS-CoV-2 infection experience a higher incidence of postoperative complications.
  • PAS teams must adapt management protocols to mitigate risks to patients and healthcare workers during pandemics.
  • Pandemic preparedness is crucial for maintaining effective care for severe obstetric conditions like PAS.
Abstract

Keywords:
COVID-19Placenta accretaSARS CoV-2biosafetypersonal protective equipmentpostoperative complications

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