Title: A 5-year experience on perinatal outcome of placenta accreta spectrum disorder managed
by cesarean hysterectomy in southern Iranian women
Version: 1 Date: 24 Dec 2020
Reviewer:  Hassan Abduljabbar
Reviewer's report:
BMC Pregnancy and Childbirth
Clinical characteristics and perinatal outcome of placenta accrete spectrum disorder: A 5-year
experience from Southern Iran.
Keyword: placenta accrete, Resource-limited, maternal, neonatal, outcome
Generally
The title reflects the study accurately.
(Clinical characteristics and perinatal outcome of placenta accrete spectrum disorder: A 5-year
experience from Southern Iran)
It is an interesting subject; it will be helpful for Obstetricians.
The study is (Not Original)
Dutta I, Osoba L. 01 Perinatal and Maternal Medicine P1. 1 Risk assessment for post-natal
depression. Risk. 2008;1:1
El Gelany S, Mosbeh MH, Ibrahim EM, Khalifa EM, Abdelhakium AK, Yousef AM, Hassan
H, Goma K, Abd Alghany A, Mohammed HF, Azmy AM. Placenta Accreta Spectrum (PAS)
disorders: incidence, risk factors and outcomes of different management strategies in a tertiary
referral hospital in Minia, Egypt: a prospective study. BMC pregnancy and childbirth. 2019 Dec
1;19(1):313.
The message of the study has good knowledge to be added to medical literature.
Abstract:
Objective: is clear but might helpful.
(This cohort study aimed to investigate the risk factors of placenta accreta spectrum (PAS)
disorder, management of affected patients, maternal and neonatal outcomes of these pregnancies
in a resource-limited setting)
• The abstract reflects the research.
• It will be nice to give what is the reason for this research??
• It is a good summary it is well written
Background
This cohort study
It is obvious and nice and starts with what is Placenta accretaspectrum ??
the incidence,
complication
some text is taken from the web
Incidence, prevalence, and gene frequency studies of .... https://jmg.bmj.com/content/15/6/409
Materials and Methods
• All women diagnosed with placenta accreta, increta, and percreta who underwent a peripartum
hysterectomy in
• a tertiary centre
• Southern Iran between
• January 2015 until October 2019
• followed and included in this study.
Maternal Variable
• Estimated blood loss,
• Transfusion requirements,
• ICU admission) and
Neonatal Variable
• Apgar score,
• NICU admission,
• Birthweight
Variables were among the primary outcome measure of this study.
Statistical analysis is appropriate.
No conflict of interest
Results
The number of 198 is adequate  PAS
During the study period, January 2015 until October 2019
163 pregnancies had an antenatal diagnosis
ultrasound examination and/or MRI.
The mean gestational age at diagnosis was 26 weeks,
the mean blood loss of the patients during surgery was 2446 ml,
mean 2 packs of red blood cells were transfuse intra-operatively.
Fifteen per cent of women had surgical complications with bladder injuries being the most
common ones.
Furthermore, 113 neonates of PAS group were admitted to NICU due to prematurity, of which
15 died (mortality rate=7.6%).
Table 1 Demographic and obstetric characteristics of the study population
Table 2 and is just descriptive.
Statistical analysis is basic.
Discussion
Poorly written need more discussion about the subjects
• Start with Management of PAS
• loss of fertility, due to hysterectomy,
• massive peripartum haemorrhage and
• need to blood products transfusion and
• ICU admission, injury to bowel and bladder,
• prolonged hospital stay and even maternal or neonatal mortality.
• PAS should be managed in a tertiary centre with multi-disciplinary coordination.
• Repetition of the study no other study to compare and review of another cautery
Conclusion
The findings of this study showed that PAS pregnancies managed in a resource-limited
setting in Southern Iran have both maternal and neonatal outcome comparable to those in
developed countries, which is considered to be mainly due to earlier antenatal diagnosis and
multidisciplinary approach used for management.
The manuscript is written in (English language with few spelling and grammar mistakes.)
Statistical analysis is fundamental.
Methods clear Institution This cohort study
Number adequate
The table illustrates the result but fundamental need more explanation.
The length of the manuscript is appropriate.
Plagiarism .. There are a few sentences in the manuscript taken from the web.
No conflicts of interests
Ethically approved
References;27  references, many references are old before 2009 not verified or not checked)