Evaluation of clinical profile, risk factors and management challenges in placenta accreta spectrum

Abstract

Placenta Accreta Spectrum (PAS), formerly known as Morbidly Adherent Placenta (MAP), refers to the range of pathological adherence of placenta, including placenta increta, placenta percreta and placenta accreta. This condition is associated with severe hemorrhage, devastating complications and considered as a challenge in terms of management options. This study aimed to evaluate the clinical profile, risk factors and complications in women with PAS. This series included four cases of Placenta accreta spectrum managed by different approaches such as radical (cesarean hysterectomy) or uterine sparing surgery according to patient’s clinical presentation, hemodynamic condition, extent of invasion and available resources. Risk factors for PAS were previous cesarean deliveries, placenta previa, first cesarean elective and history of uterine curettage. Placenta accreta was associated with various complications mainly obstetric hemorrhage. Pelvic devascularization by inflating radiologically pre-placed occlusion balloons in both internal iliac arteries was associated with less blood loss and reduction in length of inpatient stay.