Fetomaternal Outcome of Placenta Accreta Spectrum (PAS) Disorder Managed by Planned Vs. Emergency Management Modality Among Cases Admitted in A Selective Tertiary Level Hospital of Bangladesh

Author(s): Shohana Askary, Salma Rouf, Khorshed Minhajul Alam, Sadia Mahfiza Khanom, Sharmeen Sultana, Tahmina Sultana Nila, Salma Khatun, Mahbubur Rahman Razeeb

Background: Placenta Accreta Spectrum (PAS) disorder is a complex and potentially life-threatening condition where the placenta attaches too deeply into the uterine wall. This condition can lead to severe complications during delivery, including massive hemorrhage, the need for hysterectomy, and maternal or neonatal morbidity and mortality. Objectives: The aim of the study was to evaluate the fetomaternal outcome of placenta accreta spectrum (PAS) disorder managed by planned vs. emergency management modality among cases admitted in a selective tertiary level hospital of Bangladesh. Methods: This cross-sectional comparative study was carried out in the Department of Obstetrics & Gynaecology, Dhaka Medical College Hospital, Dhaka, during 18th January 2020 to 17th July 2020. A total of 74 patients were participated in the study. Among them Group-A comprised of patients who undergone planned management of PAS disorder and Group-B dealt with patients who undergone emergency management of PAS disorder). Statistical analyses of the results were be obtained by using window-based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-24). Results: The age distribution throughout the categories. The mean ± SD of age was computed as 25.4 ± 5.7 years for Group A and 25.2 ± 5.4 years for Group B. According to the operational definition, patients are divided into three socioeconomic classes. The impoverished class accounted for the majority of patients (44%), followed by the middle class (38%), and the upper class (18%). In addition, the majority of the women (56.0%) had multiple children. Parity 4+ or grand multipara was 14.0% in Group B patients. Conclusion: Planned management with a multidisciplinary team approach has better outcomes without mortality as compared to emergency management of PASD patients. Scheduled or planned management with avoiding attempt to placental removal are associated with reduced maternal morbidity in women with suspected placenta accreta.