Placenta Accreta Spectrum and Obstetric Hystrctomies in Relation to Increasing Cesarean Section

  • Tasneem Akhter Associate Professor Department of Gynaecology and Obstetrics, Bahawal Victoria Hospital Bahawalpur
  • Khiaynat Sarwar Hashmi Senior Registrar Department of Gynaecology and Obstetrics, Bahawal Victoria Hospital Bahawalpur
  • Sidrah Batool Senior Registrar Department of Gynaecology and Obstetrics, Bahawal Victoria Hospital Bahawalpur
Keywords: Placenta accrete, PAS, obstetric hysterectomy, Adherent placenta

Abstract

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.

Published
2020-03-23
Section
Original Articles