The goal of this study is to present the Jakarta Surgical Uterine Conservation (JSICA) technique and its perioperative outcomes in Placenta Accreta Spectrum patients. Participants are all patients undergoing standard hysterectomy or the Jakarta Surgical Uterine Conservation (JSICA) technique. Researchers will compare both groups to see if there are any differences in the perioperative outcomes.
This study uses data from Cipto Mangunkusumo General Hospital's Placenta Accreta Case Register. This register includes all patients with a confirmed placenta accreta spectrum diagnosis. Data collected includes demographic characteristics, risk factors, surgery characteristics, and perioperative outcomes. In this study, researchers would like to evaluate the perioperative outcomes of the JSICA technique in comparison to a standard hysterectomy.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
323
a. Identifying the placenta accrete site; b. Meticulous dissection to create a bladder flap; c. Incision 1 cm above the placenta accrete; d. Fetal delivery; e. Bottom incision to resect the placenta; f. Placental delivery; g. Uterus without placenta; h. The resection area is approximated using interrupted horizontal mattress suture; i. The continuous suture used to close all incision areas; j. Evaluation of uterine contraction
The main types of hysterectomy are abdominal, vaginal, and laparoscopic hysterectomy
Maternal Fetal Medicine Division, Obstetric Gynecology Department Cipto Mangunkusumo General Hospital
Jakarta Pusat, DKI Jakarta, Indonesia
Intraoperative bleeding
Intraoperative bleeding in this study was measured by the amount of blood loss (cc) and classified into \< 1.000 cc, 1.000-1.500 cc, and \> 1.500 cc. .
Time frame: Perioperative
Operation duration
The operation duration was the time interval from skin incision to closure (hours) and classified into \< 3 hours and \> 3 hours.
Time frame: Perioperative
Number of Patients Admitted to ICU
ICU admission was identified by the documentation of number of patients' admission to the ICU
Time frame: 24 hours
Rate of Intraoperative complications
Rate of intraoperative complications were identified by the documentation of injury to adjacent structures (bladder or ureter) or a need for transfusion.
Time frame: Intraoperative
Intraoperative Bleeding in JSICA compared to hysterectomy
Intraoperative bleeding in this study was measured by the amount of blood loss (cc) and classified into \< 1.000 cc, 1.000-1.500 cc, and \> 1.500 cc in comparison of JSICA to hysterectomy
Time frame: Perioperative
Operation duration in JSICA compared to hysterectomy
The operation duration was the time interval from skin incision to closure (hours) and classified into \< 3 hours and \> 3 hours in comparison of JSICA to hysterectomy
Time frame: Perioperative
Number of Patients Admitted to ICU in JSICA compared to hysterectomy
ICU admission was identified by the documentation of number of patients' admission to the ICU in comparison of JSICA to hysterectomy
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Time frame: 24 hours
Rate of Intraoperative complications in JSICA compared to hysterectomy
Rate of intraoperative complications were identified by the documentation of injury to adjacent structures (bladder or ureter) or a need for transfusion in comparison of JSICA to hysterectomy
Time frame: Perioperative