Shorter the cervix, more difficult the XXXX operations.

@entity1 @entity5030 @entity8052
BACKGROUND: To determine the impact of cervical length (CL) on the clinical outcome of @entity1 undergoing peripartum hysterectomy due to placenta @entity5030 /percreta. OBJECTIVE: To assess the association of CL with clinical outcomes in such @entity1 . METHODS: We analyzed the data of @entity1 who were diagnosed with anterior placenta @entity5030 /percreta prenatally and subsequently underwent peripartum hysterectomy at our tertiary care institution between 2004 and 2014. The sonographic images and measurements of CL were obtained from prospectively collected database. The duration of operation, units of blood products transfused, and length of stay in the hospital were recorded. @entity1 were stratified according to CL, and receiver-operating characteristics curves were used to determine the cut-off length for identification of @entity1 at high risk of intra-operative difficulty. RESULTS: Sixty-one @entity1 were included in this study. Number of packages of ES were correlated with the the duration of operation (r   = 0.666, p   <   0.001) and the CL (-0.793, p   <   0.001). Number of packages of fresh frozen plasma was significantly correlated with the CL (-0.642, p   <   0.001) and the duration of operation (r   =   0.606, p   <   0.001). Gestational age (AUC   =   0.683, p   =   0.014) and the CL (AUC   =   0.980, p   <   0.014) were significant predictors for the number of ES transfused   >   4 packages. The cut-off value of four packages was determined according to the median level of packages transfused. Optimal cut-off value for the CL to predict transfusion    <=   4 packages was 20.5 with 93% sensitivity and the 99% specificity. CONCLUSIONS: Short cervix appears to be a cause of difficulty in placenta @entity5030 /percreta operations. CL may also help in determining the timing of delivery in @entity8052 @entity1 .
