Abstract: Introduction: Placenta accreta spectrum refers to range of pathological adherence of the placenta including placenta accreta, placenta increta and placenta percreta. It is a disorder of abnormal placentation that causes significant morbidity and mortality.
Incidence is increasing mainly due to increased number of uterine surgeries such as caesarean sections, myomectomy.
Aim: To evaluate the maternal and fetal outcome of placenta accreta spectrum in a rural tertiary care hospital.
Methods: This retrospective study was conducted in the department of Obstetrics and Gynaecology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly during the period from January 2022 to June 2023. Patients presenting during this period with placenta accreta spectrum were included in the study. The maternal outcome was studied in terms of the amount of intrapartum blood loss, ICU admissions, prolonged hospital stay, bladder injury and disseminated intravascular coagulation.
Results: Total eighteen patients were included in the study who were diagnosed as placenta accreta spectrum either preoperatively or intraoperatively. Out of eighteen, six were placenta accreta, seven were placenta increta and five were placenta percreta. All of these patients underwent peripartum hysterectomy. Seven patients required ICU admission. Internal iliac artery balloon occlusion was performed in four patients. There were two maternal mortalities in the study.
Conclusion: There is significant increase in rate of placenta accreta in patients with history of previous caesarean section. Thorough counseling of the patient regarding morbidity of caesarean section and need for peripartum hysterectomy should be done. Antenatal diagnosis along with multidisciplinary team with planned delivery helps to improve maternal and neonatal outcome.
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