Duan Duan, Sumei Wei, Dongmei Tang, Shimao Zhang, Jinzhu Fu, Linbo Cheng, Mi Su, Wenyi Lin, Wen Xiong
{"title":"急诊/计划剖宫产对伴有胎盘增生的孕妇及其新生儿围产儿结局的影响:一项回顾性队列研究","authors":"Duan Duan, Sumei Wei, Dongmei Tang, Shimao Zhang, Jinzhu Fu, Linbo Cheng, Mi Su, Wenyi Lin, Wen Xiong","doi":"10.3389/fsurg.2025.1603425","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Placenta accreta spectrum (PAS) is an obstetric condition. This study analyzes the outcomes of PAS parturients and their newborns undergoing emergency cesarean sections as opposed to planned cesarean sections.</p><p><strong>Methods: </strong>In this research, we conduct a thorough retrospective analysis of 345 patients with placenta accreta at a single medical center. The patients were systematically categorized into two groups based on the type of surgical procedure: emergency cesarean sections and planned cesarean sections. A univariate analysis was performed to compare the outcomes associated with each approach. Furthermore, a logistic regression analysis was used to identify independent risk factors related to emergency surgeries. To further enhance our understanding, a multiple linear regression analysis was employed to determine the key factors influencing intraoperative bleeding. The selection of covariates for the regression analyses was carefully guided by previously reported influencing factors, as well as the significant differences highlighted in the univariate analysis. Missing data were addressed using multiple imputation based on chained equations to reduce potential bias and preserve analytical integrity. The study enrolled all women with PAS between August 2019 and February 2022. Ethical approval for this study was obtained from the Ethics Committee of Chengdu Women's and Children's Center Hospital (Ethics DOI: 201830). All participants provided written informed consent.</p><p><strong>Results: </strong>The amount of bleeding and allogeneic blood transfusion in mothers in the emergency group was higher than that in the planned group. In the newborns in the emergency group, birth weight, length, and gestational age were lower than those in the planned group. The analysis found that the operation mode (<i>B</i> = 158.174, <i>P</i> = 0.043, 95% CI: 4.99-311.358) and the duration of operation (min) (<i>B</i> = 13.348, <i>P</i> < 0.001, 95% CI: 11.878-14.817) significantly affected the amount of intraoperative bleeding.</p><p><strong>Conclusions: </strong>The perinatal outcomes and perinatal infant outcomes in the emergency group were worse than those in the planned group, as exemplified by a lower neonatal birth weight, shorter body length, smaller gestational age at birth, and higher incidence of severe neonatal asphyxia. An emergency cesarean section may increase the amount of bleeding during a cesarean section in patients with PAS. A multidisciplinary team managing such patients can achieve favorable outcomes.</p><p><strong>Clinical trial registration: </strong>identifier (ChiCTR2100054068).</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1603425"},"PeriodicalIF":1.6000,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406495/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effect of an emergency/planned cesarean section on the perinatal outcomes of pregnant women with placenta accreta spectrum and their neonates: a retrospective study cohort.\",\"authors\":\"Duan Duan, Sumei Wei, Dongmei Tang, Shimao Zhang, Jinzhu Fu, Linbo Cheng, Mi Su, Wenyi Lin, Wen Xiong\",\"doi\":\"10.3389/fsurg.2025.1603425\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Placenta accreta spectrum (PAS) is an obstetric condition. This study analyzes the outcomes of PAS parturients and their newborns undergoing emergency cesarean sections as opposed to planned cesarean sections.</p><p><strong>Methods: </strong>In this research, we conduct a thorough retrospective analysis of 345 patients with placenta accreta at a single medical center. The patients were systematically categorized into two groups based on the type of surgical procedure: emergency cesarean sections and planned cesarean sections. A univariate analysis was performed to compare the outcomes associated with each approach. Furthermore, a logistic regression analysis was used to identify independent risk factors related to emergency surgeries. To further enhance our understanding, a multiple linear regression analysis was employed to determine the key factors influencing intraoperative bleeding. The selection of covariates for the regression analyses was carefully guided by previously reported influencing factors, as well as the significant differences highlighted in the univariate analysis. Missing data were addressed using multiple imputation based on chained equations to reduce potential bias and preserve analytical integrity. The study enrolled all women with PAS between August 2019 and February 2022. Ethical approval for this study was obtained from the Ethics Committee of Chengdu Women's and Children's Center Hospital (Ethics DOI: 201830). All participants provided written informed consent.</p><p><strong>Results: </strong>The amount of bleeding and allogeneic blood transfusion in mothers in the emergency group was higher than that in the planned group. In the newborns in the emergency group, birth weight, length, and gestational age were lower than those in the planned group. The analysis found that the operation mode (<i>B</i> = 158.174, <i>P</i> = 0.043, 95% CI: 4.99-311.358) and the duration of operation (min) (<i>B</i> = 13.348, <i>P</i> < 0.001, 95% CI: 11.878-14.817) significantly affected the amount of intraoperative bleeding.</p><p><strong>Conclusions: </strong>The perinatal outcomes and perinatal infant outcomes in the emergency group were worse than those in the planned group, as exemplified by a lower neonatal birth weight, shorter body length, smaller gestational age at birth, and higher incidence of severe neonatal asphyxia. An emergency cesarean section may increase the amount of bleeding during a cesarean section in patients with PAS. 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Effect of an emergency/planned cesarean section on the perinatal outcomes of pregnant women with placenta accreta spectrum and their neonates: a retrospective study cohort.
Background: Placenta accreta spectrum (PAS) is an obstetric condition. This study analyzes the outcomes of PAS parturients and their newborns undergoing emergency cesarean sections as opposed to planned cesarean sections.
Methods: In this research, we conduct a thorough retrospective analysis of 345 patients with placenta accreta at a single medical center. The patients were systematically categorized into two groups based on the type of surgical procedure: emergency cesarean sections and planned cesarean sections. A univariate analysis was performed to compare the outcomes associated with each approach. Furthermore, a logistic regression analysis was used to identify independent risk factors related to emergency surgeries. To further enhance our understanding, a multiple linear regression analysis was employed to determine the key factors influencing intraoperative bleeding. The selection of covariates for the regression analyses was carefully guided by previously reported influencing factors, as well as the significant differences highlighted in the univariate analysis. Missing data were addressed using multiple imputation based on chained equations to reduce potential bias and preserve analytical integrity. The study enrolled all women with PAS between August 2019 and February 2022. Ethical approval for this study was obtained from the Ethics Committee of Chengdu Women's and Children's Center Hospital (Ethics DOI: 201830). All participants provided written informed consent.
Results: The amount of bleeding and allogeneic blood transfusion in mothers in the emergency group was higher than that in the planned group. In the newborns in the emergency group, birth weight, length, and gestational age were lower than those in the planned group. The analysis found that the operation mode (B = 158.174, P = 0.043, 95% CI: 4.99-311.358) and the duration of operation (min) (B = 13.348, P < 0.001, 95% CI: 11.878-14.817) significantly affected the amount of intraoperative bleeding.
Conclusions: The perinatal outcomes and perinatal infant outcomes in the emergency group were worse than those in the planned group, as exemplified by a lower neonatal birth weight, shorter body length, smaller gestational age at birth, and higher incidence of severe neonatal asphyxia. An emergency cesarean section may increase the amount of bleeding during a cesarean section in patients with PAS. A multidisciplinary team managing such patients can achieve favorable outcomes.
期刊介绍:
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.