Surgical Morbidity Associated with Location of Placenta in Cases of Placenta Accreta Spectrum (PAS)

Background: Higher rates of cesarean deliveries, like those in Egypt, have been linked to a higher risk of placenta accreta spectrum (PAS). Preventive care and safe birth planning of this serious condition should be enhanced by pre-delivery risk classification and knowledge of the entire spectrum of accreta risk variables. Prior to assessing the impact of placental position on risk variables and outcomes in PAS cases, there were few papers on this topic. In order to improve proactive management of PAS patients based on geography, we set out to evaluate the impact of PAS location on cesarean morbidity in addition to risk classification. Methods: This prospective cohort study was conducted at Obstetrics & Gynecology Department, Faculty of Medicine, Zagazig University on 71 women diagnosed prenatally as PAS. Placental location was defined by ultrasound images and confirmed by pathology reports. Location was categorized as anterior, posterior, or anterior/posterior for those with placental location at both sites. Results: Majority of patients had anterior placental location (53.5%), 25.4% had anterior- posterior and 21.1% had posterior placental location. Posterior type was significantly associated with not suspected prenatal. Anterior was significant associated with abnormal amniotic fluid. Posterior type significantly associated with ICU need. No significant difference founded between groups and the most prevalent post-operative complication was infection. Conclusion: Our results highlight how crucial it is to understand how age, obstetric history, and placental position affect incidence and clinical manifestation of PAS. Knowing pathophysiology of PAS enhances customized treatment plans according to patient features and placental location.