Placenta Accreta Spectrum: An Alarming Situation in Pakistan

Abstract

Placenta accreta spectrum is a generalized term used when placenta firmly adherent with uterus. It has three grades depending upon its invasion into myometrium of uterus. This condition occurs as a consequence of partial or complete absence of decidua basalis. Which allows the placental invasion into the substance of uterus so there will be no clear plane between placenta and uterus. It is a life threatening condition causes considerable fetomaternal morbidities and mortalities. Aim of this study is to determine the incidence of placenta accreta and its association with previous cesarean section. It is a descriptive cross sectional survey Conducted in tertiary care hospital of Pakistan for period of 1 year using non probability purposive sampling technique. Maximum patients about 54.61% were found between 36-42 years. According to gravidity maximum patients about 44.08% were found between G5-G7. More patients were presented about 46.88% at gestational age of 32-35 weeks and incidence of placenta previa was found 7.53% further distribution of patents of placenta previa according to scarred and un scarred uterus was 65.14% and 34.85% respectively. Incidence of placenta accreta in patients with placenta previa with scarred uterus was found 93% and 6.8% patients of placenta previa with scarred uterus have no placenta accrete. Frequency of placenta accreta in previous 1, 2, 3, 4, 5 were as 2.06%, 6.20%, 23.87%, 32.57%, and 35.31% respectively. Occurrence of placenta accreta in unscarred placenta previa was found 2.20% and placenta accrete spectrum not found in unscarred placenta previa 97.79%. Objective of this study was to find out the incidence of placenta accreta system and also determine the association of this condition with previous cesarean section. By diagnosing it antenately fetomaternal morbidities and mortalities can be reduced. And rising rate of cesarean now a days is the main cause of this condition, by controlling the rising rate of cesarean we can reduce the incidence of this condition.