A Case Series on Placenta Accreta Spectrum

BACKGROUND: Placenta accreta spectrum represents a group of abnormal placental implantation disorders characterized by partial or complete adherence of the placenta to the uterine wall, with invasion into the myometrium or beyond. It is a major cause of severe obstetric hemorrhage and is associated with significant maternal morbidity and mortality. The rising incidence of placenta accreta spectrum parallels the increasing rate of cesarean deliveries, making early diagnosis and planned multidisciplinary management crucial in modern obstetric practice. OBJECTIVES: The objective of this study is to describe the clinical presentation, antenatal diagnosis, intraoperative findings, management strategies, and maternal outcomes of placenta accreta spectrum cases encountered in a tertiary care obstetric setting. MATERIALS AND METHODS: This case series included five women diagnosed with placenta accreta spectrum and managed at a tertiary care teaching hospital over 1-year study period from January 2024 to December 2025. The clinical details, including obstetric history, risk factors, antenatal imaging findings, intraoperative diagnosis, surgical management, blood transfusion requirements, and maternal outcomes, were documented and analyzed. Diagnosis was based on antenatal ultrasonography and/or intraoperative findings consistent with placenta accreta spectrum. RESULTS: All cases had identifiable risk factors, with previous cesarean section being the most common. Placenta accreta spectrum was suspected antenatally in most cases, allowing planned delivery with multidisciplinary preparedness. Surgical management included cesarean hysterectomy in selected cases, while conservative approaches were attempted in carefully chosen patients. Significant blood loss was observed; however, timely intervention and availability of blood products resulted in favorable maternal outcomes in all cases. CONCLUSION: Placenta accreta spectrum remains a serious obstetric condition with the potential for life-threatening hemorrhage. Antenatal suspicion, early diagnosis, planned delivery, and a multidisciplinary approach are essential to reduce maternal morbidity and improve the outcomes.