Frequency and Clinical Outcome in Patients with Placenta Accreta Spectrum

Abstract

Objective: To determine the frequency and maternal and fetal outcomes in patients with placenta accreta spectrum.
Materials and Methods: This cross sectional study was conducted in department of Obstetrics & Gynaecology Unit – 1 from January 2018 – December 2021. All women who came for delivery with alive fetus during the study period were included in the study. A structured questionnaire designed to collect data was filled by the researcher. Data was entered and analysed using SPSS version 22.

Results: 305 cases with placenta accreta spectrum were reported during the course of study. Frequency of placenta accreta spectrum was 9.3/1000 deliveries. Significant association was seen in maternal mortality with patients who were diagnosed with placenta accreta spectrum during cesarean section (p-value = 0.000), patients having emergency cesarean deliveries (p-value= 0.009), patients requiring massive transfusion owing to excessive blood loss (p-value=0.01) and in cases requiring uncrossed blood or where blood products were not available in time (p-value=0.000). 15.1% of babies had early neonatal death. Early neonatal death was associated with preterm delivery (p-value=0.000), low birth weight (p-value= 0.000) and low apgar score at 1 and 5 minutes of birth (p-value=0.000).

Conclusion: Placenta accreta spectrum is associated with high risk of maternal  and perinatal morbidity and mortality.

Key words: Placenta accreta spectrum, morbidly adherent placenta, maternal morbidity, mortality