SavedAdd your journal

Journals / Harran Üniversitesi Tıp Fakültesi Dergisi / 2026 / Cilt: 23 Sayı: 2

Evaluation of the Relationship Between the Number of Cesarean Sections and Maternal and Neonatal Mortality and Morbidity in Patients with Placenta Percreta

Plasenta Perkretalı Hastalarda Sezaryen Sayısının Maternal ve Neonatal Mortalite ve Morbidite ile İlişkisinin Değerlendirilmesi

İbrahim Halil Adak(ŞANLIURFA EĞİTİM VE ARAŞTIRMA HASTANESİ)0009-0002-1602-4165
Mert Ulaş Barut(HARRAN ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0002-7008-8218
Yusuf Ziya Kızıldemir(HARRAN ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0003-0094-8275
Pages
220–229
Publication Date
2026-06-26
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

These findings suggest that preventing unnecessary cesarean deliveries may reduce the incidence of PAS and may have favorable maternal and infant health outcomes in such cases.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Background: Placental adhesion disorders (PAS), especially in cases such as placenta percreta, carry serious risks for maternal and infant health.
📊
Key Findings & Data:Materials and Methods: Between January 2021 and January 2023, 150 pregnant women admitted to Harran University Faculty of Medicine, Department of Obstetrics and Gynecology and diagnosed with placenta percreta were included in the study.
💡
Conclusion & Impact:These findings suggest that preventing unnecessary cesarean deliveries may reduce the incidence of PAS and may have favorable maternal and infant health outcomes in such cases.
🔬Design:Araştırma Makalesi
📍Scope:2021 Verileri
⚙️Variables:Plasenta Perkreta · Sezaryen · Maternal Morbidite

Abstract

Background: Placental adhesion disorders (PAS), especially in cases such as placenta percreta, carry serious risks for maternal and infant health. These disorders are associated with complications such as bleeding, transfusion requirement and multiple organ failure. The main aim of this study was to examine the effect of the number of previous cesarean sections on maternal and neonatal outcomes in pregnant women with placenta percreta. Materials and Methods: Between January 2021 and January 2023, 150 pregnant women admitted to Harran University Faculty of Medicine, Department of Obstetrics and Gynecology and diagnosed with placenta percreta were included in the study. Patients were divided into three groups according to the number of previous cesarean sections: 1-2 cesarean sections (Group 1), 3-4 cesarean sections (Group 2) and 5 or more cesarean sections (Group 3). Maternal (preoperative hemoglobin level, length of hospital stay, frequency of transfusion, postoperative complications) and neonatal outcomes (preterm delivery, APGAR scores, neonatal intensive care unit admission) were compared between the groups. Results: The mean age was 33.3±4.9 years and the mean gestational age was 34.5±2.0 weeks. The preterm delivery rate was significantly higher in Group 3 (34%) compared to Group 1 (16%) (p=0.038). Hysterectomy rate increased from 10% in Group 1 to 58% in Group 3 (p<0.001). The complication rate was also higher in Group 3 compared to Group 1 (p=0.021). There was no significant difference between the groups in terms of neonatal outcomes (APGAR scores and intensive care unit admission). Patients who underwent hysterectomy had a longer hospital stay, higher complication rates, and higher rates of neonatal intensive care unit admission. Conclusions: In cases of placenta percreta, an increasing number of previous cesarean sections increases the risk of hysterectomy, preterm delivery and maternal-neonatal morbidity. These findings suggest that preventing unnecessary cesarean deliveries may reduce the incidence of PAS and may have favorable maternal and infant health outcomes in such cases.

Özet

Amaç: Plasental yapışma anomalileri (PYA), özellikle plasenta perkreta gibi durumlarda anne ve bebek sağlığı açısından ciddi riskler taşımaktadır. Bu anomaliler kanama, transfüzyon ihtiyacı ve çoklu organ yetmezliği gibi komplikasyonlarla ilişkilidir. Bu çalışmanın temel amacı, plasenta perkreta tanılı gebelerde geçirilmiş sezaryen sayısının maternal ve neonatal sonuçlar üzerindeki etkisini incelemektir. Materyal ve metod: Ocak 2021 ile Ocak 2023 tarihleri arasında Harran Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı'na başvuran ve plasenta perkreta tanısı konulan 150 gebe çalışmaya dahil edildi. Hastalar, geçirilmiş sezaryen sayısına göre üç gruba ayrıldı: 1-2 sezaryen (Grup 1), 3-4 sezaryen (Grup 2) ve 5 veya daha fazla sezaryen (Grup 3). Gruplar arasında maternal (preoperatif hemoglobin düzeyi, hastanede kalış süresi, transfüzyon sıklığı, postoperatif komplikasyonlar) ve neonatal sonuçlar (preterm doğum, APGAR skorları, yenidoğan yoğun bakım ünitesine kabul) karşılaştırıldı. Bulgular: Ortalama yaş 33,3±4,9 yıl, ortalama gestasyonel hafta ise 34,5±2,0 hafta idi. Preterm doğum oranı, Grup 1'e (%16) kıyasla Grup 3'te (%34) anlamlı düzeyde daha yüksekti (p=0,038). Histerektomi oranı Grup 1'de %10 iken, Grup 3'te %58'e yükseldi (p<0,001). Komplikasyon oranı da Grup 1'e göre Grup 3'te daha yüksekti (p=0,021). Neonatal sonuçlar (APGAR skorları ve yoğun bakım ünitesine kabul) açısından gruplar arasında anlamlı bir fark saptanmadı. Histerektomi uygulanan hastaların hastanede kalış sürelerinin daha uzun, komplikasyon oranlarının ve yenidoğan yoğun bakım ünitesine kabul oranlarının daha yüksek olduğu görüldü. Sonuç: Plasenta perkreta vakalarında, artan geçirilmiş sezaryen sayısı; histerektomi, preterm doğum ve maternal-neonatal morbidite riskini artırmaktadır. Bu bulgular, gereksiz sezaryen doğumların önlenmesinin, PYA insidansını azaltabileceğini ve bu tür vakalarda anne ve bebek sağlığı açısından olumlu sonuçlar doğurabileceğini düşündürmektedir.

🔖

Cite This Article

Adak, İ. H., Barut, M. U., Kızıldemir, Y. Z., *, İ. H. A. (2026). Evaluation of the Relationship Between the Number of Cesarean Sections and Maternal and Neonatal Mortality and Morbidity in Patients with Placenta Percreta. Harran Üniversitesi Tıp Fakültesi Dergisi, Cilt: 23 Sayı: 2, 220–229. https://doi.org/10.35440/hutfd.1778460

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (26)

  1. Poljak B, Khairudin D, Jones NW, Agten AK. Placenta accreta spectrum: diagnosis and management. Obstet. Gynaecol. Reprod. Med. 2023;33:232-8.
  2. Matsuzaki S, Einerson BD, Sentilhes L, Sibai BM, Saade GR, Saad AF, et al. Local resection after cesarean delivery for placenta accreta spectrum disorder: a systematic review and meta-analysis. Obstet Gynecol. 2025;145(6):639-53.
  3. Einerson BD, Gilner JB, Zuckerwise LC. Placenta Accreta Spectrum. Obstet Gynecol. 2023;142(1):31-50.
  4. Viana Pinto P, Kawka-Paciorkowska K, Morlando M, Huras H, Kołak M, Bertholdt C, et al. Prevalence of fetal anomalies, stillbirth, neonatal morbidity, or mortality in pregnancies complicated by placenta accreta spectrum disorders. Acta Obstet Gynecol Scand. 2025;104(Suppl 1):38-44.
  5. Varlas VN, Bors RG, Birsanu S, Maxim B, Clotea E, Mihailov M. Maternal and fetal outcome in placenta accreta spectrum (PAS) associated with placenta previa: a retrospective analysis from a tertiary center. J Med Life. 2021;14(3):367-75.
  6. Birendra R, Jigyasa S. A retrospective study of maternal and neonatal outcome in placenta accreta spectrum after planned or emergency delivery from a tertiary care centre in North India. Cureus. 2023;15(9):44725.
  7. Oben A, Ausbeck EB, Gazi MN, Subramaniam A, Harper LM, Szychowski JM, et al. Association between Number of Prior Cesareans and Early Preterm Delivery in Women with Abnormal Placentation. Am J Perinatol. 2021;38(4):326-31.
  8. Sahu SA, Shrivastava D. Maternal and perinatal outcomes in placenta previa: a comprehensive review of evidence. Cureus. 2024;16(5):e59737.
  9. Miller SE, Leonard SA, Meza PK, Ku S, Ren LY, Lyell DJ, et al. Red Blood Cell Transfusion in Patients With Placenta Accreta Spectrum: A Systematic Review and Meta-analysis. Obstet Gynecol. 2023;141(1):49-58.
  10. Özgürlük İ, Keskin HL. Incidence of obstetric massive blood transfusion and clinicial features: hospital-based study. New Trend Med Sci. 2023;4:173-80.
  11. Alhashim ZG, Alzayer ZA, Alensaif AA, Al Darwish HA, Almomen MA, Alnsaif JM. Blood Transfusion Predictors in Cesarean Sections for Pregnancies With Placenta Accreta and Placenta Previa: A Monocentric Tertiary Experience. Cureus. 2023;15(10):e47648.
  12. Barut MU, Keklik ET, Düken RK, Sak S, Evaluation of the relationship between the number of cesarean sections and maternal and neonatal mortality and morbidity in patients with placenta percreta. J Harran Univ Med Fac. 2023;20(3):672-7.
  13. Friedrich L, Mor N, Weissmann-Brenner A, Kassif E, Friedrich SN, Weissbach T, et al. Risk factors for bladder injury during placenta accreta spectrum surgery. Int J Gynaecol Obstet. 2023;161(3):911-9.
  14. Matsuzaki S, Mandelbaum RS, Sangara RN, McCarthy LE, Vestal NL, Klar M, et al. Trends, characteristics, and outcomes of placenta accreta spectrum: a national study in the United States. Am J Obstet Gynecol. 2021;225(5):534. e1-534.e38.
  15. Moeini R, Dalili H, Kavyani Z, Shariat M, Charousaei H, Akhondzadeh A, et al. Maternal and neonatal outcomes of abnormal placentation: a case-control study. J Matern Fetal Neonatal Med. 2021;34(19):3097-103.
  16. Wang J, He Y, Fan C, Xiong G, Sun G, Wang S, et al. Analysis of factors influencing premature birth in cases with placenta previa complicated by placenta accreta spectrum disorders. Shiyong Yixue Zazhi. 2024;40(21):2982-8.
  17. Fishel Bartal M, Papanna R, Zacharias NM, Soriano-Calderon N, Limas M, Blackwell SC, et al. Planned versus Unplanned Delivery for Placenta Accreta Spectrum. Am J Perinatol. 2022;39(3):252-8. Toussia-Cohen S, Castel E, Friedrich L, Mor N, Ohayon A, Levin G, et al. Neonatal outcomes in pregnancies complicated by placenta accreta- a matched cohort study. Arch Gynecol Obstet. 2024;310(1):269-75.
  18. Sentilhes L, Seco A, Azria E, Beucher G, Bonnet MP, Branger B, et al. Conservative management or cesarean hysterectomy for placenta accreta spectrum: the PACCRETA prospective study. Am J Obstet Gynecol. 2022;226(6):839.e1-839.e24.
  19. Bluth A, Schindelhauer A, Nitzsche K, Wimberger P, Birdir C. Placenta accreta spectrum disorders-experience of management in a German tertiary perinatal centre. Arch Gynecol Obstet. 2021;303(6):1451-60.
  20. Markfeld Erol F, Häußler JA, Medl M, Juhasz-Boess I, Kunze M. Placenta accreta spectrum (PAS): diagnosis, clinical presentation, therapeutic approaches, and clinical outcomes. Medicina (Kaunas). 2024;60(7):1180.
  21. Weissbach A, Cohen E, Kassif E, Fogel L, Meller N, Leron E, et al. Outcomes of cesarean delivery in placenta accreta: conservative delivery vs. cesarean hysterectomy. J Perinat Med. 2023;52(1):22-9.
  22. Wang Q, Ma J, Zhang H, Dou R, Huang B, Wang X, et al. Conservative management versus cesarean hysterectomy in patients with placenta increta or percreta. J Matern Fetal Neonatal Med. 2022;35(10):1944-50.
  23. Pan S, Han M, Zhai T, Han Y, Lu Y, Huang S, et al. Maternal outcomes of conservative management and cesarean hysterectomy for placenta accreta spectrum disorders: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2024;24(1):463.
  24. Hage L, Athiel Y, Barrois M, Cojocariu V, Peyromaure M, Goffinet F, et al. Identifying risk factors for urologic complications in placenta accreta spectrum surgical management. World J Urol. 2024;42(1):539.
  25. Cohen A, Lambert C, Yanik M, Nathan L, Rosenberg HM, Tavella N, et al. Investigation of health inequities in maternal and neonatal outcomes of patients with placenta accreta spectrum: a multicenter study. Am J Obstet Gynecol MFM. 2024;6(7):101386.
  26. Yaghmaei M, Ajori L, Mokhtari M. Repeat cesarean sections: maternal and neonatal outcomes and complications. J Obstet Gynecol Cancer Res. 2024;9(1):95-101.