Caesarean Hysterectomy for Placenta Accreta Spectrum in a Single Centre: A Series of 19 Cases

Abstract

The objective of this study is to assess obstetric complications, blood loss, blood transfusion requirement, and maternal and fetal outcomes associated with the authors’ approach of Caesarean hysterectomy for placenta accreta spectrum disorders. Data were collected from case records of all females who underwent Caesarean hysterectomy between August 2013–August 2023 at Lifeline Multispeciality Hospital, Adoor, Kerala, India. There were 19 cases of Caesarean hysterectomy. The mean age was 33.63±2.90 years. Mean blood loss during surgery was 1.11±0.16 L, and the mean packed red blood cells transfused was 2.00±0.38 units. The mean gestational age of termination was 33 weeks and 5 days, and mean birth weight was 2.28±0.21 kg. There were no maternal or neonatal deaths. Placenta accreta spectrum should be managed in a multidisciplinary setup with the involvement of a senior experienced obstetrician. Early, careful bladder dissection before proceeding with hysterectomy will help in reducing haemorrhage, and in accelerating hysterectomy.