الفهرس 
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Abstract
The incidence of placenta accreta spectrum (PAS) diseases has increased from 0.12 to 0.31% over the past 30 years, making it a substantial and life-threatening obstetrical concern. The reported death rate associated with PAS is roughly 7.0%.
Placenta previa and placenta accrete pose a substantial risk to the health and survival of both the mother and the fetus.
Bladder injury occurring after cesarean hysterectomy necessitates the use of a urine catheter for a period of 7 to 10 days, causing discomfort to the patient. Vesicovaginal fistulas are a highly bothersome complication that can occur as a result of bladder injury.
Recent literature reports have shown that filling the bladder with 200 ml of saline solution prior to commencing a cesarean section in pelvic adhesiolysis surgery is a straightforward and beneficial technique. This technique effectively reduces the risk of bladder injury, as well as decreases operation time, intraoperative blood loss, and subsequently, hospital stay.
The primary objective of this study was to assess the effect of bladder distention after placenta accreta surgery on mother outcome.
This study was conducted using a prospective randomized controlled design and included a total of 100 patients who were diagnosed with placenta accreta and underwent a cesarean section procedure. The study period spanned from January 1, 2023, to June 30, 2023. The study was conducted at the Minia Maternity and Children university hospital in Egypt. The patients were randomly allocated into two groups. The first group consisted of 50 patients who did not have their urinary bladder filled during placenta accreta surgery, whereas the second group consisted of 50 patients who did have their urinary bladder filled during the surgery.
The main results of the study revealed that:
• In the first group, the mean age was 27.14 ± 3.52, while in the second group it was 27.06 ± 3.28. In the first group, the mean weight was 78.12 ± 4.26, while in the second group, it was 77.6 ± 4.13. The groups were not significantly different from one another.
• In the first group, the mean parity was 1.42 ± 0.54, while in the second group, it was 1.32 ± 0.59. In both the first and second groups, the average gestational age was 2.82 ± 0.72 and 2.64 ± 0.88, respectively. The first group had an average of 1.26 ± 0.51 previous cesarean sections, while the second group had an average of 1.38 ± 0.57. The average gestational age in the first group was 36.32 ± 1.66 weeks, while in the second group it was 36.08 ± 1.58 weeks. The groups were not significantly different from one another.
• The average systolic blood pressure in the first group was 113.1 ± 2.55, while in the second group it was 113.34 ± 2.7. The average diastolic blood pressure in the first group was 75 ± 2.23 and in the second group it was 74.1 ± 2.58, similarly. In the first group, the mean pulse was 71.42 ± 2.39, while in the second group, it was 71.7 ± 2.31. The first group had an average temperature of 36.78 ± 0.08 and the second group had an average temperature of 36.79 ± 0.09. The groups were not significantly different from one another.
• In the first group, the mean hemoglobin level was 14.97 ± 0.82, while in the second group, it was 14.88 ± 1.01. In the first group, the mean leucocytic count was 7005 ± 992.54, while in the second group, it was 7065.96 ± 1041.17. The average platelet count in the first group was 305.06 ± 31.14 while in the second group it was 315.2 ± 35.15. The first group had an average Pro thrombin time of 13.26 ± 1.51, while the second group had an average of 13.06 ± 1.54. In the first group, the mean INR was 1.09 ± 0.1, while in the second group, it was 1.11 ± 0.1. The groups were not significantly different from one another.
• 15 patients in the group whose bladders were not filled experienced bladder injuries as a result of the operation. Although five participants in the filled bladder group experienced bladder injuries. The groups were significantly different from one another (p = 0.012).
• In the first group, the average operation time was 103.02 ± 27.52 minutes, while in the second group, it was 88.62 ± 26 minutes. In the first group, the average length of time spent in the hospital was 5.67 ± 3.99 days, while in the second group, it was 5.44 ± 2.96 days. In the first group, the average fresh frozen plasma transfusion was 2.47 ± 1.4, while in the second group, it was 2.49 ± 1.45.
• The first group had an average erythrocyte transfusion of 3.17 ± 1.53, while the second group had an average of 3.08 ± 1.72. The average blood loss in the first group was 2559 ± 122.59 and in the second group it was 2166.4 ± 84.12.
• Three patients in the first group were admitted to the intensive care unit. But in the second group, there were just two patients. Regarding blood loss (p = 0.009) and duration of hospital stay (p = 0.03), there was a statistically significant difference between the groups.