A Retrospective study of association of risk factors, incidence and fetomaternal outcome of Placenta Accreta Spectrum (accrete, increta, percreta) in a Tertiary Care Institute

Abstract

Introduction – Placenta Accreta Spectrum is a complex obstetrical condition of abnormal placental invasion associated with severe maternal morbidity. The aim of current research is to study the association of various risk factors with the placenta accrete spectrum and to study the incidence and feto-maternal outcome in placenta accrete spectrum.
Material and methods- The present retrospective study was conducted at department of obstetrics and gynaecology of a tertiary care centre for a period of two years among patients of placenta accreta spectrum. Through convenience sampling out of 400 cases of placenta previa, total 40 cases of placenta accreta spectrum cases were identified . The software used for statistical analysis was SPSS package 22 (SPSS, Chicago, IL).
Results – Out of 40 cases of placenta accreta spectrum 44.11% were of placenta accreta, 42.64% were of placenta percreta and 13.23% were of placenta increta. The most common complaint was bleeding from vagina (95%). Patients living in urban area (75%) were more
affected as compare to those living in rural area (25%). Out of all the patients 60% had gestational age of 16 to 30 weeks, 30% had 30 to 34 weeks and 10% had 34 to 38 weeks. The maternal outcome shows more complicated situation in urgent cases as compared to elective cases. The birth weight of babies of GA 32 to 38 weeks was around 2.5 kgs, GA 28 to 32 had birth weight of around 1.2+0.5 kgs and GA 14 to 28 weeks had birth weight of 600-1000g. APAGAR score was 10, 8 and 4 respectively in three groups.
Conclusion – Due to surgical difficulty, conservative management should only be used for extensive disease and the desire for fertility. Strategic management and early risk factor identification may enhance the outcomes for both mothers and fetuses.