Placenta Accrete Spectrum-Fetomaternal Outcome In A Tertiary Care Hospital Of Assam

Background: Placenta Accreta Spectrum (PAS) is a serious obstetrics condition in which the placenta abnormaly invades the uterine wall, extending partially or fully into the myometrium and sometimes up to the serosa. This abnormal implantation significantly increases the risk of complication for both the mother and the baby, including severe haemorrhage, the need for blood transfusion, and higher likelihood of requiring a hysterectomy at the time of delivery. Objective: The objective of this study was to ascertain the clinical presentation and evaluate maternal and fetal outcome in cases of Placenta Accreta Spectrum managed at a tertiary care hospital. Method: This prospective observational study included all patients presenting to the Antenatal Outpatient Department, Emergency Labour Room, High-Risk Pregnancy Room and Intensive care unit. Detailed history of current and previous pregnancies were recorded. Routine and general examinations were conducted and patient were followed until discharge. Result: A total of 45 patient were diagnosed with PAS during this study period with an incidence of 0.28%. In the study incidence came out be 0.28%. Mean age of PAS was 30.6 +/-1.6. years. Major risk factors were placenta previa (80%) and history of previous LSCS (73.9%%) and Multiparity(93.3%). Among the three types( 55.6%) patients had placenta accrete,(15.6%)had placenta increta and (28.9%) patients had placenta percreta. Major maternal complications seen in cases of PAS were bladder injury (6.7%). Intraoperative blood loss more than 1.5L was seen in (55.6%) and 2 patients required more than 5 units of Blood Transfusion. There was no mortality rate. Requirement of caesarean hysterectomy was seen in 33.3% cases. Pre-term delivery was seen in 66.7%, low birth weight was seen in 53.3% of the cases, NICU admission was seen in 24.4%. Conclusion: Accurate prenatal diagnosis of PAS allows for timely planning by a multidisciplinary team, significantly reducing the risk of surgical complications, maternal blood loss, and prolonged ICU stays. Early detection and comprehensive care are crucial to improve both maternal and fetal outcome in pregnancies complicated by PAS.