Prevalence and main outcomes of morbid adherent placenta: a tertiary center experience

Background: The objective of this study was to evaluate the prevalence of placenta accreta spectrum and the main maternal outcomes at delivery.Method: this is a retrospective study for maternal outcome in tertiary obstetric centers of Shiraz University of Medical Science (Namazi, Hafez, Hazrate Zeinab, Shahid Faghihi hospitals), from 2014- 2019 patients with placenta accrete specterum report in pathology sample post cesarean section hysterectomy.Result: this study include 170 patients with documented pathology diagnosis: 77accrete, 52 increta, 41 precreta placenta. 22-45 years old women with mean 32.6±4.9 and gravida 1-9 with mean 3.7±1.5. 167 patients had scar on uterus 50 patients one previous cesarean, 77 women 2 previous cesarean, 37 of them 3 previous cesarean scar and 2 women had 4 cesarean scar, one of them only had a D&C in past history. 3 patients without scar and any risk factor one G2l1 (NVD) and 2 patients was gravida 1 but unfortunately had pathology of accreta syndrome. 17 patients had hysterectomy under gestational age of viable fetus due to maternal problem or fetal anomaly. 60 patients had cesarean between 34 -36 week of gestation and 61 with gestational age more than 36 weeks with significant better neonatal outcome without difference in maternal outcome.Conclusion: We should consider this pathology in every patient with uterine scar. In these centers we terminate patients at 34-35 weeks of gestation if they have reliable ultrasonography or MRI for placenta accrete syndrome but better neonatal outcome without significant complication in mothers is good document to change this plan and have pregnancy termination like parkland hospital in 36-37 weeks.

کلیدواژه ها:

placenta accrete ، prevalence ، outcome