The efficacy of LigaSure™ open instruments in cases of cesarean hysterectomy due to placenta percreta: a retrospective, record-based, comparative study.

OBJECTIVE: The standard treatment for patients with placenta percreta is cesarean hysterectomy that can cause severe bleeding. New-generation vessel sealing systems like LigaSure can cut and seal vascular structures and tissues. The aim of this study was to retrospectively compare hysterectomies performed with traditional instruments and those performed with LigaSure instruments to determine the possible advantages with the latter. MATERIALS AND METHODS: Patients with placenta percreta who underwent elective cesarean hysterectomy by the same surgeon were divided into two groups based on the type of instruments used. Group 1, the standard conventional hysterectomy group, operated with conventional instruments for cutting and tying; and Group 2, the LigaSure hysterectomy group, operated with the new-generation bipolar sealing and cutting instruments. The groups were retrospectively compared for bleeding, operating time, and complications. RESULTS: In Group 2, the operating time, intraoperative and total transfused erythrocyte suspension units, total fluid in the drain, and total hospital stay were lower than in Group 1 (p < .05), as was the need for internal iliac artery ligation (p = .013). The complication rates were similar between the two groups (p > .05). CONCLUSION: The use of LigaSure open instruments in cesarean hysterectomies in patients with placenta percreta may reduce operating times and the amount of bleeding.

Factors associated with antenatal depression during the COVID-19 (SARS-CoV2) pandemic: A cross-sectional study in a cohort of Turkish pregnant women.

PURPOSE: To determine the effect of the COVID-19 pandemic on antenatal depression in Turkish pregnant women. DESIGN AND METHODS: In this cross-sectional study, data were collected from 497 pregnant women between May and July 2020 using the Edinburgh Depression Scale (EDS) to determine the effect of obstetrics history, fear of hospitalization, concerns about the pandemic, birth, and the health of both mother and infant, on antenatal depression during the COVID-19 outbreak in Turkey. FINDINGS: The general EDS mean score of the total group was determined as mean 13.70 ± 6.22, which was higher than the critical cutoff point of 13. According to the multiple linear regression model applied in the study, the best predictive variables for the mean EDS score were determined to be concerned about completing a healthy pregnancy (r = -0.45), social media and news programs related to COVID-19 increasing levels of concern (r = -0.31), fear of hospitalization as the birth approaches (r = -0.45), having bad dreams during the COVID-19 pandemic (r = -0.41), the request for an elective cesarean delivery because of fear of catching COVID-19 (r = -0.40), fear of breastfeeding the infant (r = -0.45), and concerns that their own health would be negatively affected because of the pandemic (r = - 0.39), and these variables affected the mean EDS score negatively (total variance 40.5%, R = 0.642). PRACTICAL IMPLICATIONS: The COVID-19 pandemic has created an urgent need to implement specific antenatal programs to promote the psychological health of pregnant women and reduce antenatal depression during this or similar crises.