Maternal Outcomes in Placenta Accreta Spectrum: Experience at Lady Reading Hospital Peshawar, Pakistan

Abstract

Background: Placenta accrete spectrum includes placenta accreta, increta and percreta and results in failure of placental separation from uterine wall after delivery. It can cause massive hemorrhage and is one of the major cause of maternal mortality.Objectives: To determine maternal outcomes in placenta accreta spectrum (PAS) at Lady Reading hospital PeshawarMaterial and Methods: This cross-sectional study was carried in OBGYN department of Lady Reading hospital Peshawar from January 1st 2022 till 31st December2022. Patients with placenta accreta spectrum were included for study. These cases were recruited from antenatal OPD and from obstetric emergency unit. Mode of delivery in all cases was cesarean section. All included patients were followed till discharge to determine maternal and fetal outcomes. Information was gathered on pre designed proformas.Results: The mean age of sample of 35 cases was 33 +-3.5 years. Mean gestational age at delivery was 34+-1.01. Sixty eight percent cases of placenta percreta spectrum had emergency cesarean delivery. Thirty four percent cases received multidisciplinary intra operative care. Hemorrhage needing blood and blood products transfusion was the commonest intra operative complication accounting for 68.6% cases. Surgical wound infection was the commonest post operative complication occurring in 31.4% cases. Two mothers died during the study period.Conclusion: Hemorrhage is the most common complication of placenta percreta spectrum.Keywords: placenta percreta, obstetric hemorrhage, surgical wound infection