PLACENTA ACCRETA: IS PRIMARY ELECTIVE CAESAREAN SECTION A PREDISPOSING RISK FACTOR?

Abstract

Background:

Placenta accrete spectrum is a fatal obstetrical condition associated with serious fetomaternal morbidity and mortality. It is associated with a variety of risk factors including primary elective caesarean section. To determine the association of placenta accreta spectrum with primary elective caesarean section.
Materials & Methods:

This case-control study was conducted over two years (June 2022 to May 2024) at Sir Ganga Ram Hospital, Lahore, including 100 pregnant women with placenta previa. Demographic and obstetric details were noted in all patients and their caesarean section and postoperative management were done as per hospital policy. Intraoperatively type of placenta previa and type of placenta accreta spectrum was noted. Based on intraoperative findings 50 women with placenta previa, adherent placenta, and one or more previous caesarean sections were
enrolled in Group A (cases), while 50 women with placenta previa and previous caesarean sections were enrolled in Group B (controls). Maternal outcomes along with demographic and obstetric details were noted in preformed proforma and analyzed using SPSS. Results were considered statistically significant with a p-value less than 0.05.
Results:

The number of elective primary lower segment caesarean section (LSCS) were higher in Group A (cases) 37 (74%) than 27 (54%) in Group B (controls) (P value= 0.037). Amongst women with placenta accreta spectrum in Group A (cases), the present study found placenta accreta in 64%, placenta increta in 22%, and placenta percreta in 14% of women.
Conclusion:

Elective primary caesarean section is associated with a higher risk of placenta accreta spectrum.