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All Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Placentum: Jurnal Ilmiah Kesehatan dan Aplikasinya
Nugraha, Gagah Baskara Adi
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Health Professions Medicine & Pharmacology Nursing Public Health

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Multidisciplinary Approach of Placenta Accreta Spectrum Management to Reduce Blood Loss and Prevent Organ Injury in Referral Center Nugraha, Gagah Baskara Adi; Yuliantara, Eric Edwin
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 3 Jully 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i3.2098

Abstract

Objective: To investigate the differences in blood loss and organ injury at our PAS referral center over the past six years.Methods: This retrospective analytical study included 150 subjects diagnosed with PAS based on histopathological findings from 2018 to 2023 at the PAS Center of Dr. Moewardi Regional Hospital, Surakarta, Indonesia. Subjects were divided into two groups: before 2020 and after 2021, based on multidisciplinary team appointments.Results: The highest number of Placenta Accreta Spectrum (PAS) cases occurred in 2020, with 36 patients. Hysterectomy was the most frequently performed procedure for managing PAS in all groups. However, differences in blood loss, organ injury, and length of hospital stay between the periods from 2018 to 2020 and 2021 to 2023 were statistically significant (p < 0.05).Conclusion: Multidisciplinary approaches involving various medical specialties and teams are essential to ensure maternal safety and effectively manage massive blood loss and organ damage during PAS surgery procedures.Keywords: Placenta accreta spectrum, Blood loss reduction, Organ injury prevention.
Early Detection and Good Team Collaboration for Preventing Maternal Death Caused by Placenta Accreta Spectrum Disorder Yuliantara, Eric Edwin; Bachnas, Muhammad Adrianes; Anggraini, Nutria Widya Purna; Prabowo, Wisnu; Nugraha, Gagah Baskara Adi; Chasanah, Meriska Dewi; Alim, Fadel Muhammad S.; Merina, Hikmah F.
Placentum: Jurnal Ilmiah Kesehatan dan Aplikasinya Vol 11, No 2 (2023): August
Publisher : Program Studi Kebidanan Fakultas Kedokteran Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/placentum.v11i2.71047

Abstract

Background: Placenta accreta spectrum (PAS) is considered one of the most harmful pregnancy conditions, as it is strongly linked with maternal morbidity and mortality. An accurate and early prenatal diagnosis of PAS allows time for a multidisciplinary team to plan the best course of action for delivery management. The aim of this study is to describe placenta accreta spectrum management and outcomes with early detection and a multidisciplinary team approach.Method: A retrospective cohort study was conducted on 167 cases of placenta accreta from 2016 to 2021. Medical records were then reviewed, and data were collected for delivery management and maternal outcome, including estimated amounts of bleeding, urinary tract injury, delivery time, ICU referral, and maternal death.Result: Delivery management (hysterectomy and conservative management) and maternal bleeding were significantly associated with MAP score (p < 0.05), while urinary tract injury, delivery time, ICU admission, and maternal death were not significantly associated (p > 0.05). 55.1% of patients underwent hysterectomy, and the rest 44.9% underwent conservative surgery. Massive bleeding of more than 2500 mL happened in 54.5% of patients, and the rest 45.5% managed to bleed less than 45.5%. Preterm deliveries accounted for 29.9% of all deliveries, with the remaining 70.1% being term. 5.4% of patients experienced urinary tract injuries. 6.6% of patients were referred to the intensive care unit. The maternal mortality rate is 4.8%.Conclusion: Early detection of the placenta accreta spectrum, as well as good collaboration among members of a multidisciplinary team from various medical fields, are required to ensure the mother and baby's safety and survival.
Co-Authors Alim, Fadel Muhammad S. Bachnas, Muhammad Adrianes Chasanah, Meriska Dewi Eric Edwin Yuliantara Merina, Hikmah F. Nutria Widya Purna Anggraini WISNU PRABOWO