MATERNAL OUTCOME IN PLACENTA ACCRETA SPECTRUM DISORDER IN TERTIARY CARE HOSPITAL.

Objective: To study maternal outcome in placenta accreta spectrum disorder in ANC patients of Vanivilas hospital. Materials and Methods: After obtaining approval and clearance from the institutional ethics committee, the in-patient and out-patients fulfilling the inclusion criteria will be enrolled for the study after obtaining informed consent. Details collected as per the case record and follow up form. A study was conducted among 40 suspected cases of placenta accreta spectrum disorder, data regarding general information, demographic data, obstetric history, gestational age, risk factors, management, blood loss, blood products transfusion, organ injury, outcome, HPE report, outcome(mortality & morbidity) are collected. The collected data is then compiled and analyzed. Results: 40 cases of PAS were managed over 1 year period, where PAS accounted for 0.276% out of 14000 deliveries conducted at Vanivilas hospital. 47.5% were belonging to the age group between 26-30yr, PAS has led to 5% of maternal death, 82.5% had morbidity which includes 30% had blood loss between 1.6-2liters, 27.5% had massive hemorrhage(>2lt), maximum blood loss was 3.5lt. 5% had sepsis, 5% with postpartum bleeding, 2.5% had acute renal failure, 20% had bladder injury, 2.5% had ureteric injury, 22.5% had prolonged hospital stay(>7 days), 15% had SSI. Conclusion: PAS accounted for 0.276% out of total deliveries in a year at Vanivilas hospital (14K) PAS disorders are an important cause of maternal morbidity (82.5%) and mortality(5%). Commonest risk factor being previous scarred uterus with placenta previa (85%) Sensitivity rate of USG in picking up adherent placenta is 31.5%, 80% were managed by peripartum hysterectomy, 10% required postpartum hysterectomy. 28.12% had bladder/ureteric injury, 85% required ICU stay, 22.2% required prolonged hospital stay, 87.5% required blood & blood products transfusion. 83.3% were HPE confirmed adherent placenta. [ABSTRACT FROM AUTHOR]