TIÊN LƯỢNG BẢO TỒN TỬ CUNG DỰA TRÊN HÌNH ẢNH SIÊU ÂM TRONG PHẪU THUẬT RAU TIỀN ĐẠO TRUNG TÂM RAU CÀI RĂNG LƯỢC

Abstract

Objectives: Evaluate the role of ultrasound signs and the ability to preserve the uterus in placenta accreta surgery. Subjects and methods: Retrospective descriptive study of 76 pregnant women diagnosed with placenta accreta and cesarean section scars treated at Hanoi Hospital. Results: 76 pregnant women participated in the study, there was no difference in the rate of each single ultrasound sign with the possibility of conservation or hysterectomy with p > 0.05. There is a statistically significant difference in the ability to preserve the uterus between the group with less than 2 signs on ultrasound and the group with 2 or more signs on ultrasound (p = 0.006 < 0.01, Se = 100% , Sp = 19%). There is a statistically significant difference in the hysterectomy rate between the group of pregnant women with 3 or more signs on ultrasound and the group with less than 3 signs on ultrasound (with p = 0.023 < 0.05, Se = 58 .8%, Sp = 66.7%, OR = 2.86), pregnant women with signs of blood vessels perpendicular to the uterine muscle had higher blood loss than the group without this sign with p = 0.047. Conclusions: There is no single ultrasound sign that decides whether to undergo a hysterectomy or preserve the uterus, but pregnant women with 3 signs on ultrasound have a high prognosis for hysterectomy during surgery.