Abstract
(1) Background: Placenta accreta spectrum (PAS) is a pathologic invasion of the placental trophoblasts to the myometrium and beyond. This study evaluates the demographic features, risk indicators, feto–maternal outcome, and treatment options in PAS women at our center. (2) Methods: This is a retrospective study carried out in 39 patients with placenta accreta spectrum in our tertiary health care center Sri Maharaja Gulab Singh (SMGS) Hospital, from July 2019 to September 2020. (3) Results: Most patients in our study were in the 30–35 years age group. The previous lower segment Caesarean section (LSCS) was the most critical risk factor for PAS in our research. Thirty-two of the women with PAS (82.05%) had undergone a hysterectomy, and eight patients did not undergo a hysterectomy. Twenty-eight patients needed Intensive Care Unit (ICU) care, 13 of them required ventilatory support, and three of them died due to hemorrhagic shock. In our study, preterm birth occurred in 26 patients (53.84%), while 21 (53.8%) required Neonatal Intensive Care Unit (NICU) admission, and six (15.4%) had early neonatal death and stillbirth. (4) Conclusion: PAS is a devastating event in women’s pregnancy. It leads to high maternal morbidity, mortality, and adverse neonatal outcome. The critical risk indicators for PAS are previous LSCS and placenta previa. Every case with these two concurrent conditions should be operated on in a planned way in the presence of senior obstetricians and of an anesthesiology team.
Highlights
“Placenta accreta spectrum (PAS), formerly known as the morbidly adherent placenta, is de ned as pathologic invasion of the placental trophoblasts to the myometrium and beyond” [ ]. It is divided into several types described as accreta, increta, and percreta [ – ]
Our study evaluates the demographic pro le, high-risk factors, materno–fetal outcome, and management options in women of PAS at our center
Perhaps the most important ultrasonographic association of placenta accreta spectrum in the second and third trimesters is the presence of placenta previa, which is present in more than % of accretes
Summary
“Placenta accreta spectrum (PAS), formerly known as the morbidly adherent placenta, is de ned as pathologic invasion of the placental trophoblasts to the myometrium and beyond” [ ]. It is divided into several types described as accreta (adheres to the myometrium), increta (invades deep to the myometrium), and percreta (the invasion reaches to the uterine serosa and beyond) [ – ]. The treatment in females with PAS is planned hysterectomy with the placenta in situ with no attempt to deliver the placenta Despite such an ideal approach, PAS is still associated with high maternal morbidity and mortality [ , ]. In India, obstetric hemorrhage is one of the signi cant causes of maternal mortality ( %) This may be because most women in India are already anemic before they start bleeding [ ]. Our study evaluates the demographic pro le, high-risk factors, materno–fetal outcome, and management options in women of PAS at our center
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