Determinants of spectrum and fetomaternal outcome of morbid adherent placenta: An observational study

Abstract

The objective of the study was to determine the factors underlying maternal and fetal outcomes of Placenta Accreta Spectrum (PAS). This observational, prospective study was conducted during a period of four years. A total of 9080 patients were admitted in Obstetrics & Gynaecology department throughout this duration. Out of which 147 were diagnosed with the history of antepartum haemorrhage with pregnancy. Full term, near term patients or patients with massive antepartum haemorrhage underwent emergency or elective caesarean section while patients diagnosed in the second or early third trimester on ultrasound or with mild antepartum haemorrhage treated conservatively. In our study, we found that the frequency of Placenta Accreta Spectrum was 1.6%. The average age of the participants was 28.08 years, with age ranging between 17 to 42 years. Most participants lived in urban areas (46%), and a significant number were grand multiparous (70%). We observed that a history of previous caesarean section (62%) and previous placenta previa (68%) increased the risk of PAS. During surgery, the most common complication was bleeding (11.5%), followed by bladder injury (8.8%). The occurrence of PAS cases has significantly risen in the recent years. The PAS is linked with serious health risks for both the baby and the mother. It's crucial to implement strategies aimed at reducing the rate of caesarean sections to mitigate the associated complications, such as placenta previa and PAS, which pose significant risks to maternal and fetal health.