Placenta Accreta Spectrum and Obstetric Hystrctomies in Relation to Increasing Cesarean Section
Objective: To see the association between the PAS and previous uterine surgeries, the morbidity and rate of hysterectomy associated with it.
Methodology: It was a prospective observational study conducted over a period of 18 months from July 2017 to December 2018 in Department of Obstetrics and Gynecology Bahawal Victoria Hospital.
Results: The age range of all the women in the study was from 19 to 39 years. Of 6675 cesareans 1176(17.6%) were placenta previa. Of these 356 (30%) cases of placenta previa were in an unscarred uterus and 820(70%) were in scarred uterus. 487 cases were having varied degree of placental invasion. 414 (85%) were diagnosed as having placental invasion before surgery. 73(15%) cases were diagnosed as having adherent placenta per operatively. 283/487 (58%) patients had obstetric hysterectomy and conservative surgery was done in rest 204 (42%) cases.10 patients were reopened because of continued bleeding. 06 patients were those in whom conservative surgery was done and 04 were these in who obstetric hysterectomy was already done.
Conclusion: Proper risk management, antenatal diagnosis, planned /elective surgery with multidisciplinary approach and anticipating the worst can help lessen the morbidity associated with PAS.
Copyright (c) 2020 Journal of the Society of Obstetrics and Gynaecologists of Pakistan
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.