Open AccessMaternal and fetal outcome in placenta accreta spectrum (PAS) associated with placenta previa: a retrospective analysis from a tertiary center
Author(s) -
Valentin Varlas,
Roxana Georgiana Borș,
Simona Birsanu,
Bogdan Maxim,
Eliza Cloțea,
Maria-Emanuela Mihailov
Publication year - 2021
Publication title -
journal of medicine and life
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.354
H-Index - 36
eISSN - 1844-3117
pISSN - 1844-122X
DOI - 10.25122/jml-2021-0134
Subject(s) - placenta previa , placenta accreta , medicine , obstetrics , hysterectomy , retrospective cohort study , placenta , pregnancy , gynecology , gestational age , fetus , advanced maternal age , surgery , genetics , biology
Accreta placenta spectrum is a complex obstetrical condition of abnormal placental invasion associated with severe maternal morbidity. This study aimed to analyze our therapeutic management and counseling of the cases with placenta accreta spectrum (PAS) associated with placenta previa. We performed a retrospective study of pregnant women with PAS associated with placenta previa at the Filantropia Clinical Hospital between January 2017–April 2021. In these cases, the earlier diagnosis was realized by an ultrasonographic scan and was confirmed by histopathological findings after the surgical treatment. The conservative management was obtained in one case at <37 weeks of gestation, and the maternal outcome was uterine preservation. Among the 12 patients, the mean age was 34±3.44 years. All women had risk factors for abnormally invasive placenta, such as placenta previa or previous cesarean delivery. Most women underwent planned cesarean delivery at the mean gestational age of 36.4±0.9 weeks. In our study, the uterus was preserved in only one case (8.33%), and hysterectomy with preservation of ovaries was performed in the rest of the cases. Mean maternal blood loss during surgery was 2175±1440 ml. Severe maternal outcomes were recorded only in one case (8.33%). We identified a low uterine preservation rate and a good perinatal outcome. Conservative management should be reserved for fertility desire and extensive disease due to surgical difficulty. Early identification of the risk factors and strategic management may improve maternal and fetal outcomes.