Upaya Memperkecil Komplikasi Spektrum Plasenta Akreta
Abstract
Abstrak
Spektrum plasenta akreta (SPA) meningkatkan morbiditas dan mortalitas pada seorang ibu hamil. Seksio sesarea berulang merupakan faktor risiko utama untuk terjadinya SPA. Mortalitas sering terjadi pada keadaan perdarahan masiv pada tindakan seksio sesarea emergensi tanpa diagnosis SPA yang tepat pada antenatal care. Persiapan preoperasi yang kurang baik terutama jumlah cadangan darah yang tidak mencukupi mengakibatkan kematian maternal terutama di perifer atau rumah sakit dengan sarana yang kurang lengkap. Selain itu faktor tenaga medis yang kurang berpengalaman cukup menentukan karena akan meningkatkan individual stress yang meperburuk performa seorang operator.
Deteksi dini merupakan kunci untuk mengurangi operasi dengan SPA yang tidak terduga. Deteksi dini menggunakan ultrasonografi merupakan tindakan lini pertama. Operasi terhadap kasus dengan SPA sebaiknya dilakukan di rumah sakit tersier atau yang mempunyai tim tenaga medis telah terlatih penanganan SPA. Pembentukan tim medis diperlukan terutama berasal dari obstetrikus, anestesi, perawatan intensif serta bedah vaskuler.
Kata Kunci: Spektrum Plasenta Akreta, Deteksi Dini, Ultrasonografi.
Abstract
Placental accreta spectrum (PAS) increases morbidity and mortality in a pregnant woman. Recurrent caesarean section is a major risk factor for PAS. Mortality often occurs in the state of masive hemorrhage in the emergency caesarean section act without a proper PAS diagnosis in antenatal care. Poor preoperative preparations, especially the insufficient amount of blood reserves result in maternal death, especially in peripheral or hospitals with incomplete means. In addition, the factors of less experienced medical personnel are quite decisive because it will increase individual stress that worsens the performance of an operator.
Early detection is key to reducing operations with PAS that are unexpected at the time of caesarean section. Early detection using ultrasound is a first-line action. Surgery on cases with PAS should be done in tertiary hospitals or those that have a team of medical personnel who have trained in PAS handling. The formation of a medical team is needed mainly between obstetrics, anesthesia, intensive care and vascular surgery.
Keyword: Placenta Accreta Spectrum, Early Detection, Ultrasound.
Keywords
References
American College of Obstetricians and Gynecologists; Society for Maternal-Fetal Medicine. Obstetric Care Consensus No. 7: Placenta Accreta Spectrum. Obstet Gynecol. 2018 Dec;132(6):e259-e275. doi: 10.1097/AOG.0000000000002983.
Mogos MF, Salemi JL, Ashley M, Whiteman VE, Salihu HM. Recent trends in placenta accreta in the United States and its impact on maternal-fetal morbidity and healthcare-associated costs, 1998-2011. J Matern Fetal Neonatal Med. 2016;29(7):1077-82.
doi: 10.3109/14767058.2015.1034103.
Tantbirojn P,Crum CP,Parast MM. Pathophysiology of placenta accreta: the role of decidua and extravillous trophoblast. Placenta 2008;29:639–45
Badr DA, Al Hassan J, Salem Wehbe G, Ramadan MK. Uterine body placenta accreta spectrum: A detailed literature review. Placenta. 2020;95:44–52. doi:10.1016/j.placenta.2020.04.005.
Bluth, A., Schindelhauer, A., Nitzsche, K. et al. Placenta accreta spectrum disorders—experience of management in a German tertiary perinatal centre. Arch Gynecol Obstet 303, 1451–1460 (2021). https://doi.org/10.1007/s00404-020-05875-x
L. M. Ernst, R. L. Lin, L. Minturn, and E. S. Miller, “Placental pathologic associations with morbidly adherent placenta: potential insights into pathogenesis,” Pediatric and Developmental Pathology, vol. 20, no. 5, pp. 387–393, 2017.
Jacques SM, Qureshi F, Trent VS, Ramirez NC. Placenta accreta: mild cases diagnosed by placental examination. Int J Gynecol Pathol. 1996 Jan;15(1):28-33. doi: 10.1097/00004347-199601000-00005.
Jain, N., Patwardhan, S., Jain, H. et al. Surgical strategies for placenta percreta invading the bladder and review of literature. Afr J Urol. 2020;26 (57).
https://doi.org/10.1186/s12301-020-00065-2.
Nieto-Calvache AJ, Palacios-Jaraquemada JM, Vergara-Galliadi LM. All maternal deaths related to placenta accreta spectrum are preventable: a difficult-to-tell reality. AJOG Global Report.August 2021;1 (3). 100012.
https://doi.org/10.1016/j.xagr.2021.100012
Wright JD, Pri-Paz S, Herzog TJ, Shah M, Bonanno C, Lewin SN, Simpson LL, Gaddipati S, Sun X, D'Alton ME, Devine P. Predictors of massive blood loss in women with placenta accreta. Am J Obstet Gynecol. 2011 Jul;205(1):38.e1-6. doi: 10.1016/j.ajog.2011.01.040.
Nieto-Calvache, Albaro & Palaios‐Jaraquemada, Jose & Osanan, Gabriel & Cortes‐Charry, Rafael & Aryananda,et al. Lack of experience is a main cause of maternal death in placenta accreta spectrum patients. Acta Obstetricia Et Gynecologica Scandinavica.2021;10.1111/aogs.14163.
Chrouser KL, Xu J, Hallbeck S, Weinger MB, Partin MR. The influence of stress responses on surgical performance and outcomes: Literature review and the development of the surgical stress effects (SSE) framework. AJS. 2018; 216. 573e584.
https://doi.org/10.1016/j.amjsurg.2018.02.017
Rac MWF, Wells CE, Twickler DM, Moschos E, McIntire DD, Dashe JS. Placenta accreta and vaginal bleeding according to gestational age at delivery. Obstet Gynecol. 2015 Apr;125(4):808-813. doi: 10.1097/AOG.000000000000.
Jauniaux, Eric & Collins, Sally & Burton, Graham. (2017). The Placenta Accreta Spectrum: Pathophysiology and Evidence-based Anatomy for Prenatal Ultrasound Imaging. American journal of obstetrics and gynecology. 218. 10.1016/j.ajog.2017.05.067.
http://dx.doi.org/10.1016/j.ajog.2017.05.067
El Gelany, S., Ibrahim, E.M., Mohammed, M. et al. Management of bleeding from morbidly adherent placenta during elective repeat caesarean section: retrospective -record -based study. BMC Pregnancy Childbirth.2019;19(106) . https://doi.org/10.1186/s12884-019-2244-4.
Turan OM, Shannon A, Asoglu MR, Goetzinger KR. A novel approach to reduce blood loss in patients with placenta accreta spectrum disorder. J Matern Fetal Neonatal Med. 2021 Jul;34(13).p.2061-2070. doi: 10.1080/14767058.2019.1656194.
Sentilhes L, Seco A, Azria E, Beucher G, Bonnet MP, Branger B, Carbillon L, Chiesa C, Crenn-Hebert C, Dreyfus M, Dupont C, Fresson J, Huissoud C, Langer B, Morel O, Patrier S, Perrotin F, Raynal P, Rozenberg P, Rudigoz RC, Vendittelli F, Winer N, Deneux-Tharaux C, Kayem G; PACCRETA Study Group. Conservative management or cesarean hysterectomy for placenta accreta spectrum: the PACCRETA prospective study. Am J Obstet Gynecol. 2021 Dec 14:S0002-9378(21)02655-7. doi: 10.1016/j.ajog.2021.12.013.
Papillon-Smith J, Hobson S, Allen L, Kingdom J, Windrim R, Murji A. Prophylactic internal iliac artery ligation versus balloon occlusion for placenta accreta spectrum disorders: A retrospective cohort study. Int J Gynaecol Obstet. 2020 Oct;151(1):91-96. doi: 10.1002/ijgo.13256. Epub 2020 Jun 29. PMID: 32506473.
Chou MM, Chen MJ, Su HW, Chan CW, Kung HF, Tseng JJ, Chen WC, Chen YF, Yuan JC. Vascular control by infrarenal aortic cross-clamping in placenta accreta spectrum disorders: description of technique. BJOG. 2021 May;128(6):1030-1034. doi: 10.1111/1471-0528.16605.
Rylski B, Beyersdorf F, Czerny M, Siepe M. Two Aortic Ruptures in Two Months-Role of Cross-Clamp-Associated Late Injury. Ann Vasc Surg. 2016 Apr;32:129.e17-9. doi: 10.1016/j.avsg.2015.10.022.
Rosenbloom JI, Hirshberg JS, Stout MJ, Cahill AG, Macones GA, Tuuli MG. Clinical Diagnosis of Placenta Accreta and Clinicopathological Outcomes. Am J Perinatol. 2019;36(2):124-129. doi:10.1055/s-0038-1670635
Kondoh E, Kawasaki K, Chigusa Y, et al. Optimal strategies for conservative management of placenta accreta: a review of the literature. Hypertens Res Pregnancy.2015;3:19–27. DOI:10.14390/jsshp.3.19
Machado LS. Emergency peripartum hysterectomy: Incidence, indications, risk factors and outcome. N Am J Med Sci. 2011;3(8):358-361. doi:10.4297/najms.2011.358
Moretti F, Merziotis M, Ferraro ZM, Oppenheimer L, Fung KFK.The Importance of a Late First Trimester Placental Sonogram in Patients at Risk of Abnormal Placentation. Case Reports in Obstetrics and Gynecology Volume 2014, Article ID 345348, 4 pages. http://dx.doi.org/10.1155/2014/345348
Doulaveris G, Ryken K, Papathomas D, Stone J, Roman AS, Dar P,et al. Early prediction of placenta accreta spectrum in women with prior cesarean delivery using transvaginal ultrasound at 11 to 14 weeks. American Journal of Obstetrics & Gynecology MFM.2020;2(4).p.100183. DOI:https://doi.org/10.1016/j.ajogmf.2020.100183.
Dikke G, Ostromenskiy V. Interruption of Pregnancy in Women with the Uterine Scar: Potential Risks. In: Lakhno I, ed. Induced Abortion and Spontaneous Early Pregnancy Loss - Focus on Management.London:IntechOpen;2019.
Available from: https://www.intechopen.com/chapters/67430
doi: 10.5772/intechopen.86282.
Rahimi-Sharbaf F, Jamal A, Mesdaghinia E, Abedzadeh-Kalahroudi M, Niroomanesh S, Atoof F. Ultrasound detection of placenta accreta in the first trimester of pregnancy. Iran J Reprod Med. 2014;12(6):421-426.
Society of Gynecologic Oncology; American College of Obstetricians and Gynecologists and the Society for Maternal–Fetal Medicine, Cahill AG, Beigi R, Heine RP, Silver RM, Wax JR. Placenta Accreta Spectrum. Am J Obstet Gynecol. 2018 Dec;219(6):B2-B16. doi: 10.1016/j.ajog.2018.09.042. PMID: 30471891
Juan-Clar M, Torrent M, Santandreu P, Arejola E, Ibarra J, Tubau A: Effectiveness of Ultrasound Screening for a Placenta Accreta Spectrum Using Standard Ultrasound Criteria in a Secondary Care Setting. Fetal Diagn Ther. 2022;49:52-59. doi: 10.1159/000521738.
Riteau AS, Tassin M, Chambon G, et al. Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta. PLoS One. 2014;9(4):e94866. Published 2014 Apr 14. doi:10.1371/journal.pone.0094866
Dwyer BK, Belogolovkin K, Tran L, Rao A, Carroll I, Barth R,et al. Prenatal Diagnosis of Placenta Accreta: Sonography or Magnetic Resonance Imaging?. Ultrasound Med. 2008 September ; 27(9): 1275–1281.
Gulati, Anshika & Anand, Rama & Aggarwal, Kiran & Agarwal, Shilpi & Tomer, Shaili. Ultrasound as a Sole Modality for Prenatal Diagnosis of Placenta Accreta Spectrum: Potentialities and Pitfalls. Indian Journal of Radiology and Imaging.2021; 31(10).1055/s-0041-1735864.
Lional KM, Tagore S, Wright AM. Uterine conservation in placenta accrete spectrum (PAS) disorders: A retrospective case series: Is expectant management beneficial in reducing maternal morbidity? Eur J Obstet Gynecol Reprod Biol. 2020 Nov;254:212-217. doi: 10.1016/j.ejogrb.2020.09.029.
Takeda S, Takeda J, Murayama Y. Placenta Previa Accreta Spectrum: Cesarean Hysterectomy. Surg J (N Y). 2021 May 25;7(Suppl 1):S28-S37. doi: 10.1055/s-0040-1721492.
Kondoh E.Expectant Management of Placenta Accreta Spectrum Disorders. Surg J (NY) 2021;7(suppl S1):S2–S6 DOI https://doi.org/ 10.1055/s-0040-1722240.
DOI: 10.24815/jks.v23i1.25833
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