Comparison of Spinal and General Anesthesia on Maternal and Neonatal Outcomes in Pregnancies With Placenta Accreta Spectrum: A Retrospective Study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 50
- 主要终点
- Length of Hospital Stay to Discharge
研究概览
简要总结
Placenta accreta spectrum (PAS) is a serious pregnancy complication in which the placenta grows abnormally into the uterine wall. This condition is associated with a high risk of severe bleeding, need for blood transfusion, hysterectomy, and maternal complications during cesarean delivery.
This study aims to compare spinal anesthesia and general anesthesia in pregnant women diagnosed with placenta accreta spectrum who underwent cesarean delivery. The researchers reviewed existing medical records to evaluate differences in maternal and neonatal outcomes between the two anesthesia approaches.
The primary outcomes include changes in hemoglobin levels before and after surgery, the need for uterotonic medications during and after the operation, and newborn Apgar scores. Because this is a retrospective observational study, no new treatments were given, and all data were collected from routine clinical care records.
The findings are expected to help guide anesthetic decision-making in PAS cases, improve maternal and neonatal safety, and contribute to the international scientific literature on this topic.
详细描述
This is a single-center, retrospective observational study conducted in pregnant patients diagnosed with placenta accreta spectrum (PAS) who underwent cesarean delivery at Gaziantep City Hospital. Medical records were reviewed to identify eligible cases between the predefined study period based on imaging findings, intraoperative diagnosis, and/or histopathological confirmation of PAS.
Patients were categorized according to the type of anesthesia received during cesarean delivery: spinal anesthesia or general anesthesia. The choice of anesthetic technique was based on routine clinical practice, multidisciplinary team decision, and individual patient characteristics, rather than random assignment. No additional interventions were introduced for research purposes.
Data were extracted from electronic medical records, anesthesia charts, obstetric files, and neonatal records. Collected variables included demographic characteristics, obstetric history, imaging findings suggestive of PAS, intraoperative management strategies, estimated blood loss, transfusion requirements, use of uterotonic agents, and perioperative hemodynamic parameters. Neonatal data included gestational age at delivery, birth weight, Apgar scores at 1 and 5 minutes, need for resuscitation, and admission to neonatal intensive care.
The primary analytic focus was the comparison of perioperative hemoglobin change between the spinal and general anesthesia groups. Secondary analyses evaluated differences in intraoperative and postoperative uterotonic requirements, transfusion needs, surgical complications, length of hospital stay, and neonatal outcomes.
Statistical analyses were performed using appropriate parametric or non-parametric tests depending on data distribution. Potential confounding factors such as placenta previa status, prior cesarean history, and PAS severity were considered in subgroup analyses.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 45 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Pregnant patients diagnosed with placenta accreta spectrum (PAS), Undergoing elective cesarean delivery, Receiving either spinal anesthesia or general anesthesia during cesarean section, Singleton pregnancy, Availability of complete medical and anesthesia records related to surgery and perioperative management
排除标准
- •Patients without a diagnosis of PAS, Emergency (non-elective) cesarean deliveries, Use of anesthesia techniques other than spinal or general anesthesia, Multiple pregnancy (twins or more) ,Incomplete or missing medical/anesthesia records, Missing key perioperative or neonatal outcome data
研究组 & 干预措施
Spinal Anesthesia
This cohort includes pregnant patients diagnosed with placenta accreta spectrum who underwent cesarean delivery under spinal anesthesia as part of routine clinical care. The anesthetic technique was selected by the multidisciplinary clinical team based on standard institutional practice and individual patient characteristics. No experimental intervention was applied for research purposes.
干预措施: spinal anesthesia (Procedure)
General Anesthesia
This cohort includes pregnant patients diagnosed with placenta accreta spectrum who underwent cesarean delivery under general anesthesia as part of routine clinical care. The anesthetic technique was selected by the multidisciplinary clinical team based on standard institutional practice and individual patient characteristics. No experimental intervention was applied for research purposes.
干预措施: General Anesthesia (Procedure)
结局指标
主要结局
Length of Hospital Stay to Discharge
时间窗: Postoperative day of hospital discharge, assessed up to 30 days after cesarean delivery.
Total duration of maternal hospitalization calculated from the time of cesarean delivery until official hospital discharge.
Perioperative Hemoglobin Change
时间窗: From preoperative assessment to 48 hours after cesarean delivery
The difference between preoperative hemoglobin level and postoperative hemoglobin level measured within the first 48 hours after cesarean delivery in patients with placenta accreta spectrum.
Neonatal Apgar Score at 1 and 5 Minutes
时间窗: At 1 minute and 5 minutes after birth
Neonatal Apgar scores assessed at 1 and 5 minutes after birth in infants delivered by cesarean section in pregnancies with placenta accreta spectrum.
次要结局
未报告次要终点
研究者
Recep Karakaşoğlu
Principal Investigator
Gaziantep City Hospital