Placenta Accreta Spectrum; Risk Factors, Complications, Advantages and Disadvantages to Decrease Maternal Morbidity and Mortality

سال انتشار: 1403
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 32

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شناسه ملی سند علمی:

JR_JOGCR-9-5_006

تاریخ نمایه سازی: 30 مرداد 1403

چکیده مقاله:

Background & Objective: Placenta Accreta Spectrum (PAS) is a condition in pregnant women where trophoblastic tissue attaches abnormally to the uterus myometrium, causing maternal deaths. Major risk factors include placenta previa and cesarean delivery, which is increasing without medical indication. This study was conducted with aim to explore the risk factors of PAS, clinical outcomes of affected patients, and strategies to minimize maternal morbidity and mortality.Materials and Methods: A total of ۱۴۲ women who had undergone at least one cesarean delivery in the past were included. Among them, ۸۵ women had placenta accreta spectrum (PAS) in their current pregnancy (group ۱), while ۵۷ did not have PAS (group ۲). The information regarding their demographics and previous gynecological history, including placenta previa were collected. P<۰.۰۵ was considered statistically significant.Results: The risk of placenta accreta spectrum (PAS) is significantly higher in cases where there has been a previous cesarean delivery and placenta previa (p<۰.۰۵). There were no significant differences between past elective or emergent cesarean delivery (p>۰.۰۵). PAS was associated with more emergent cesarean deliveries (p<۰.۰۰۱) and hysterectomies (p<۰.۰۰۱). Moreover, ۹۷% of patients with history of placenta previa developed PAS (p<۰.۰۰۱). Most of the patients who underwent hysterectomy had PAS and placenta previa (p<۰.۰۰۱). There was no significant correlation between previous hysteroscopies and curettages and a higher risk of PAS (p>۰.۰۵).Conclusion: Women with previous cesarean delivery are significantly at risk of placenta accreta in their future pregnancies. Pregnant women should avoid insisting on elective cesarean delivery without medical indication. Planned cesarean delivery could reduce the maternal complications.

نویسندگان

Seyed Mojtaba Alavi

Student Research Committee, School of Medicine, Qom University of Medical Sciences, Qom, Iran

Mohammad Hosein Arjmandnia

Department of Pediatrics, School of Medicine, Hazrat-e Fateme Masoume Hospital, Qom University of Medical Sciences, Qom, Iran

Meysam Feizollahjani

Department of Pediatrics, School of Medicine, Hazrat-e Fateme Masoume Hospital, Qom University of Medical Sciences, Qom, Iran

enayatollah Noori

Department of Medicine, School of Medicine, Qom University of Medical Science, Qom, Iran

Maryam Yousefi

Department of Obstetrics and Gynaecology, School of Medicine, Qom University of Medical Science, Qom, Iran

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