Evidence map›Paper›PMID 41102762›Full record

ArticleBMC pregnancy and childbirth2025

The critical role of diagnostic accuracy in differentiating uterine dehiscence and placenta accreta spectrum to enhance neonatal outcomes in complex cesarean sections.

Kartika Darma Handayani, Avianita Dewi Kusumawardhani, Anang Endaryanto, Lavenia Kurniawati, Gondo Mastutik, Dina Angelika, Risa Etika, Martono Tri Utomo, Pieter J J Sauer, Rozi Aditya Aryananda

Abstract read
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Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Kartika Darma HandayaniDoctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Avianita Dewi KusumawardhaniDepartment of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Anang EndaryantoDepartment of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia. anang.endaryanto@fk.unair.ac.id.
Lavenia KurniawatiDepartment of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Gondo MastutikDepartment of Anatomic Pathology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Dina AngelikaNeonatology Division, Department of Child Health, Soetomo General Hospital, Surabaya, Indonesia.
Risa EtikaDepartment of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Martono Tri UtomoDepartment of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Pieter J J SauerDepartment of Pediatrics, Neonatology Division, University of Groningen, Groningen, The Netherlands.
Rozi Aditya AryanandaDepartment of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.

Funding

Penelitian Unggulan 2024, Clinical Research Unit, Dr. Soetomo General Hospital 39750000
6 · The paper itself

Abstract

aimThis study aims to analyze the key factors that contribute to adverse neonatal outcomes in complex cesarean sections with a high risk of placenta accreta spectrum (PAS).

methodsA retrospective analysis was conducted on 454 records collected between January 2018 and December 2023 at a single tertiary hospital, Dr. Soetomo General Hospital, Surabaya, East Java. The PAS diagnosis was confirmed intraoperatively. Clinical outcomes, including gestational age, birth weight, birth length, Apgar score at 5 min, NICU admission, and neonatal complications, were compared between the PAS and uterine dehiscence groups. Adverse neonatal outcome is defined as Apgar score of less than 7 in 5 min. Univariate and multivariate logistic regression analyses were employed to identify factors associated with composite adverse neonatal outcomes.

resultsA total of 443 cases with high suspicion of PAS were included in the analysis, of which 383 were confirmed as PAS and the remaining as uterine scar dehiscence. Multivariable binary logistic regression revealed that preterm delivery was significantly associated with an increased risk of composite adverse neonatal outcomes (adjusted odds ratio [aOR] 5.50; 95% confidence interval [CI]: 3.46–8.53; p< 0.001). Furthermore, emergency surgery was identified as a significant risk factor (aOR 2.37; 95% CI: 1.04–4.00; p= 0.001). When comparing PAS and uterine dehiscence cases, the latter group had significantly higher gestational age at delivery (p = 0.002), better 5-minute Apgar scores (p < 0.001), greater birth weight (p < 0.001), longer birth length (p = 0.047), shorter hospital stay (p < 0.001), and a lower incidence of respiratory distress syndrome (p = 0.010).

conclusionPreterm delivery and emergency delivery are primary risk factors contributing to composite adverse neonatal outcomes in pregnancies complicated by high-risk PAS. Early detection, detailed prenatal planning, and targeted clinical management are essential strategies to reduce adverse neonatal outcomes in these high-risk cases.

Indexed as

Cesarean SectionPlacenta AccretaSurgical Wound DehiscenceAdultApgar ScoreBirth WeightDiagnosis, DifferentialFemaleGestational AgeHumansInfant, NewbornPregnancyPregnancy OutcomeRetrospective StudiesRisk FactorsCaesarean sectionsNeonatal managementPlacenta accreta spectrum (PAS)Prematurity

Identifiers

PMID41102762
PMCPMC12532401

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.