Early diagnosis, a step towards reducing mortality in placenta accreta spectrum: a case series

Abstract

The worldwide incidence of placenta accrete spectrum (PAS) is increasing day by day, mostly due to the increasing trends in caesarean section (CS) rates. PAS is accountable for high maternal morbidity and mortality as it is associated with extensive haemorrhage, which often requires hysterectomy, multiple blood and blood product transfusions, ureteric and bladder injuries and prolonged ICU stay. The aim of this case series is to highlight the importance of early diagnosis and high degree of suspicion of PAS for a planned management in decreasing maternal morbidity and mortality. Antenatal patients who were associated with PAS and managed in obstetrics and gynaecology department, Kalinga institute of medical sciences, Bhubaneswar during the time period of 2 years were critically reviewed and are being presented as case series. High degree of suspicion, pre operative radiological diagnosis, well preparedness and multidisciplinary approach help us in reducing the maternal mortality and morbidity significantly. Conservative management of PAS can preserve future fertility but should only be done in hospitals with 24 hour emergency care and enough expertise as it carries high chances of maternal complications.