Experience on placenta accreta spectrum disorders and multidisciplinary way of approach in its management: a retrospective study over 2 years in a tertiary care centre
Introduction: Placenta accreta spectrum (PAS) refers to the pathologic adherence of the placentaat the defective endometrial myometrial interface leading to defective decidualization causing life-threatening haemorrhage when attempted to separate at the time of delivery thus requiringattention for a multidisciplinary approach in its management.
Aims and objectives: To study therisk factors, antenatal diagnosis, and different management approaches, associated with placentaaccreta and also to compare the maternal and fetal outcomes by different management strategies.
Methods: A retrospective analysis was done for two years from October 2019 to October 2021 withclinically diagnosed cases of PAS. We examined antenatal risk factors favouring diagnosis,peripartum morbidity and different management approaches such as vaginal delivery and curettage,by planned or emergency hysterectomy.
Results: 18 cases were studied showing a proportion of1.48 per 1000 live births. The median age for diagnosis was made around 33 weeks of gestationusing ultrasonography evidence in 77% of cases. Placenta accreta was seen in 66%, placenta incretain 27% and percreta in 5%. the median amount of blood loss was around 2500 ml, 83% of casesrequired blood transfusions, 44% required ICU admission and 27% of newborns required NICUadmission
Conclusion: PAS should be managed with a well-coordinated team in good settings toreduce maternal morbidity and mortality preferably at the tertiary care level
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