Fetomaternal Outcome and Management of Placenta Accreta Spectrum at Tertiary Care Centre

Dr Priyanka Deswal, Dr Rekha Jakhar, Dr Ankita Chaudhary, Dr. Nishu Rani, Dr. Jyoti Thakkanavar

Abstract: Introduction: Placenta accreta spectrum is a condition when part of the placenta or the entire placenta, invades and is inseparable from the uterine wall. In most of the cases, PAS is associated with serious feto - maternal complications including massive blood loss, urologic and bowel injuries, ICU admissions, re - exploration, DIC, increased rate of NICU admissions, sudden IUD and overall increased maternal and fetal morbidity and mortality. Aims & Objectives: To evaluate the demographic profile, management options and feto - maternal outcome in women with Placenta accreta spectrum at a tertiary care centre. Material And Methods: This was a prospective study which included 25 pregnant females with placenta previa and prior caesarean delivery in their third trimester. Data including demographic profile, risk factors and feto - maternal outcome was collected and statistically analysed to obtain the results. Results: Out of 25 cases, 12 were found to be in PAS group and remaining 13 represented the non - PAS group. In PAS group 6 patients underwent hysterectomy, had increased intraoperative blood loss > 2 litres, prolonged hospital stay, increased need of blood transfusions, Mortality among cases of placenta accreta was found to be 8.33%. NICU admission was required in 50% cases in PAS group out of which two died in early neonatal period. Conclusion: Placenta accreta is an obstetric emergency. Prenatal diagnosis is essential in planning the multidisciplinary approach in delivery to reduce the risk of possible fetomaternal complications.

Keywords: placenta accreta spectrum, obstetrical hemorrhage, fetomaternal complication, antenatal diagnosis, placenta previa