Abstract
Objectives To evaluate the maternal and neonatal outcomes of expected and
unexpected pathologically proven placenta accreta spectrum (PAS) cases in a
single multidisciplinary center.
Material and Methods This was a retrospective cohort study of 92 PAS cases
from January 2011 until September 2021. Only cases with histopathologically
invasive placentation were included in the study. The cases diagnosed at the
time of delivery were defined as unexpected PAS (uPAS) and those diagnosed
antenatally as expected PAS (ePAS). Maternal and neonatal outcomes of both
groups were compared.
Results Thirty-five (38%) of 92 cases were in the uPAS group.
Placenta previa and high-grade PAS (percreata) were significantly higher in the
ePAS group (p=0.028, p<0.001; respectively). The mean packed red
blood cell transfusion was significantly higher in the uPAS group
(p=0.030) but transfusions of other blood products were similar in the
two groups. There was no significant difference in intraoperative complication
rates between the two groups. Preterm delivery (<37 weeks) was
significantly higher in the ePAS group (p<0.001), but there was no
significant difference between the two groups in terms of adverse neonatal
outcomes.
Conclusions Our single center data show that although ePAS cases include
more highly invasive PAS cases, maternal hemorrhagic morbidity is lower than
uPAS cases. Reducing maternal morbidity in PAS cases can be achieved by
increasing antenatal diagnosis.
Key words placenta accreta spectrum - placenta percreta - multidisciplinary management - prenatal diagnosis
