Research Article | | Peer-Reviewed

Placenta Accreta Spectrum: An Alarming Situation in Pakistan

Received: 27 December 2023    Accepted: 12 January 2024    Published: 23 January 2024
Views:       Downloads:
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.

Published in Journal of Gynecology and Obstetrics (Volume 12, Issue 1)
DOI 10.11648/j.jgo.20241201.12
Page(s) 8-13
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Placenta Accreta Spectrum, Cesarean Section, Fetomaternal Outcome

References
[1] ACOG placenta accreta committee opinion 2012; 529: re-affirmed 2015.
[2] Rizvi SM, Fayaz F, Demographic profile and high risk factors in morbidly adherent placenta. Int J Reprod Contracept Obstet Gynecol. 2016; 5: 1617-1620.
[3] Wortman A, Alexander L, Placenta accreta, increta and percreta. Obsterics& Gynaecology Clinic of north America 2013; 40: 137-154.
[4] Thia EW, Tan LK, Devendra K, et al. Lessons learnt from two women with morbidily adherent placentas and a review of literature. Ann Acad Med Singapore 2007; 36: 298-303.
[5] Tripp Nelson. The morbidly adherent placenta Revista perucina de Ginecologia y Obstericia 2006; 62: 411-419.
[6] Cunningham FG, Leveno KJ, Bloom SL, et al. (2014) William’s Obstatrics 24th edition page 806.
[7] Tovbin J, Melcer Y, Shor S. Prediction of MAP using as scoring system. Ultrasound obstet Gynecol. 2016; 48: 504-510.
[8] Jauniaux E, Collins S, Burton GJ. Placenta accreta spectrum: pathophysiology &evidence based anatomy for prenatal ultrasound imaging. Am J Obstet gynecol. 2017; 17: 30731-30737.
[9] Kamara M, Kamara JJ, Henderson DA, et al. The risk of placenta accreta following primary elective caesarean delivery: a case control study. BJOG 2013; 120: 879-886.
[10] Fitzpatrick KE, Sellers S, Spark P, et al. The management and outcomes of placenta accrete, increta and percreta in the UK: a population based descriptive study. BTOG 2014; 121: 62-71.
[11] Society for Maternal fetal medicine. Clinical opinion. Placenta accrete. AJOG 2010; 116: 431-439.
[12] Silver RM, Landon MB, Rouse DJ, et al. Maternal morbidity associated with multiple repeat caesarean deliveries. National institute of child health and Human Development-Maternal fetal medicine unit network. Obstetrics and Gynaeclogy 2006; 107: 1226-1232.
[13] shreyasi S, Chanchal S, Sohani V, et al. Prenatal diagnosis &management of morbidly adherent placenta. J Clin Diagn Res. 2017; 11: 1-2.
[14] Chaudhari HK, Shah PK, D’Souza N. Morbidly adherent placenta: its management &maternal &perinatal outcome. J Obstet Gynecol. 2017; 49: 559-563.
[15] Tikkanen M, Stefanovic V, Paavonen J. Placenta previa percreta left in situ-management by delayed hysterectomy: a case report. Journal of medical case report 2011; 5: 418-421.
[16] Bhide A, Sebire N, AbuHamad A, et al. Morbidly adherent placenta: the need for standardization. Ultrasound Obstet Gynecol. 2017; 49: 559-563.
[17] Fox KA, Shamshirsaz A, Carusi D, et al. Conservative management of morbidly adherent placenta: Expert review. AJOG 2015; 213: 775-760.
[18] Herath RP, Wijesinghel. Management of morbidly adherent placenta. Sri Lanka journal of Obstetrics and Gynaecology 2011; 213: 775-760.
[19] Royal Australian and newzealand college of obstetricians and gynaecologist. Placenta accrete-college statement C Obs. 20. 2013.
[20] Usta IM, Hobeika EM, Musa AA, Gabriel GE, Nassar AH. Placenta previa-accreta: risk factors and complications. AM J Obstet Gynecol 2005; 193: 1045-9.
[21] Shellhaas CS, Gilbert S, Landon MB, Varner MW, Leveno KJ, Hauth JC, et al. The frequency and complication rate of hysterectomy accompanying cesarean delivery. Eunice Kennedy shriver national institutes of health and human development maternal fetal medicine units network. Obstet Gynecol2009; 114: 224-9.
[22] Wu S, Kocherginsky M, Hibbard JU. Abnormal placentation: twenty-year analysis. Am J Obstet Gynecol 2005; 192: 1458-61.
[23] Read JA, Cotton DB, Miller FC. Placenta accrete: changing clinical aspect and outcome. Obstet Gynecol 1980; 56: 31-4.
[24] Miller DA, Chollet JA, Goodwin TM. Clinical risk factors for placenta previa-placenta accrete. Am J Obstet Gynecol 1997; 177: 210-4.
[25] Mogos MF, Salemi JL, Ashley M, Whiteman VE, Salihu HM, Recent trends in placenta accrete in the united states and its impact on maternal fetal morbidity and healthcare associated cost, 1998-2011. J Maternal Feral Neonatal Med 2016; 29: 1077-82.
[26] Eshkoli T, Weintraub AY, Sergienko R, Sheiner E. Placenta accrete: risk factors outcomes and consequences for subsequect births. AM J Obstet Gynecol 2013; 208: 219. el-7.
[27] Bowman ZS, Eller AG, Bardsley TR, Greene T, Varner MW, Silver RM, Risk Factors for placenta accrete: a large prospective cohort. Am j perinatol 2014; 31: 799-804.
[28] Marshall NE, FU R, Guise JM. Impact of multiple cesarean deliveries on maternal morbidity: a systematic review. Am J Obstet Gynecol 2011; 205: 262. el-8.
[29] Garmi G, Salim R. Epidemiology, etiology, diagnosis and management of placenta accrete. Obstet Gynecol Int 2012; 2012: 873929.
[30] Baldwin HJ, Patterson JA, Nippita TA, Torvaldsen S, Ibiebele I, Simpson JM, et al. Antecedents of abnormally invasive placenta in primiparous women: risk assoiated with gynecologic procedures. Obstet Gynecol 2018; 131: 227-33.
Cite This Article
  • APA Style

    Asghar, S., Cheema, S. A., Cheema, N. A. (2024). Placenta Accreta Spectrum: An Alarming Situation in Pakistan. Journal of Gynecology and Obstetrics, 12(1), 8-13. https://doi.org/10.11648/j.jgo.20241201.12

    Copy | Download

    ACS Style

    Asghar, S.; Cheema, S. A.; Cheema, N. A. Placenta Accreta Spectrum: An Alarming Situation in Pakistan. J. Gynecol. Obstet. 2024, 12(1), 8-13. doi: 10.11648/j.jgo.20241201.12

    Copy | Download

    AMA Style

    Asghar S, Cheema SA, Cheema NA. Placenta Accreta Spectrum: An Alarming Situation in Pakistan. J Gynecol Obstet. 2024;12(1):8-13. doi: 10.11648/j.jgo.20241201.12

    Copy | Download

  • @article{10.11648/j.jgo.20241201.12,
      author = {Sadia Asghar and Samra Asghar Cheema and Najaf Asghar Cheema},
      title = {Placenta Accreta Spectrum: An Alarming Situation in Pakistan},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {12},
      number = {1},
      pages = {8-13},
      doi = {10.11648/j.jgo.20241201.12},
      url = {https://doi.org/10.11648/j.jgo.20241201.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20241201.12},
      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.
    },
     year = {2024}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Placenta Accreta Spectrum: An Alarming Situation in Pakistan
    AU  - Sadia Asghar
    AU  - Samra Asghar Cheema
    AU  - Najaf Asghar Cheema
    Y1  - 2024/01/23
    PY  - 2024
    N1  - https://doi.org/10.11648/j.jgo.20241201.12
    DO  - 10.11648/j.jgo.20241201.12
    T2  - Journal of Gynecology and Obstetrics
    JF  - Journal of Gynecology and Obstetrics
    JO  - Journal of Gynecology and Obstetrics
    SP  - 8
    EP  - 13
    PB  - Science Publishing Group
    SN  - 2376-7820
    UR  - https://doi.org/10.11648/j.jgo.20241201.12
    AB  - 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.
    
    VL  - 12
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • Department of Obstetrics and Gynecology, Naizi Medical and Dental College, Sargodha, Pakistan

  • Department of Obstetrics and Gynecology, Ganga Ram Hospital, Lahore, Pakistan

  • Department of Obstetrics and Gynecology, Ganga Ram Hospital, Lahore, Pakistan

  • Sections