A Study on Incidence, Risk Factors, and Maternal Outcome of Placenta Accreta Spectrum in a Tertiary Care Hospital

Abstract

Background: Placenta accreta spectrum (PAS) refers to abnormal adherence of the placenta, including accreta, increta, and percreta, which can lead to severe maternal morbidity and mortality due to complications such as hemorrhage, invasion into adjacent organs, and need for blood transfusions.
 
Methods: This retrospective study was conducted at the Government Maternity Hospital, Hanamakonda, Kakatiya Medical College, from January 2024 to June 2024. Data were collected on women presenting with PAS based on clinical and radiological diagnosis, including antenatal and intraoperative findings. Maternal demographic data, risk factors, and outcomes were analyzed.
 
Results: Among 2,700 deliveries, 16 cases of PAS were identified (incidence: 0.59%). PAS subtypes consisted of 7 accreta, 5 increta, and 3 percreta. Major risk factors included advanced maternal age (56% ≥ 30 years), higher parity (81.2% gravidity 3 or more), previous lower-segment cesarean section (LSCS) in 87.5%, and history of D&C (31.2%). Placenta previa was present in 62.2% of cases. Unbooked status and late referrals were common (68.7%). Preterm termination occurred in 87.5% of cases, and 56.2% underwent cesarean hysterectomy. There was no reported perioperative maternal mortality or significant postoperative complications.
 
Conclusion: Placenta accreta spectrum is increasingly recognized, i.e., PAS is being diagnosed and understood in more cases than in the past, because both the actual number of cases and clinical ability to diagnose the condition have increased dramatically in recent years, particularly among women with prior cesarean deliveries and placenta previa. Timely diagnosis, multidisciplinary management, and referral to tertiary care are essential to improve maternal outcomes.