Prevalence, Risk factor, maternal and fetal outcome of placenta accreta spectrum managed at Saint Paul’s hospital millennium medical college: a 5 years retrospective study

Abstract

Abstract Background: Placenta accreta spectrum (PAS) disorders have become a significant life threatening issue due to its increased incidence, morbidity and mortality. Several studies have tried to identify the risk factors for PAS disorders. The ideal management for PAS disorders is a matter of debate. there has not been studies conducted in SPHMMC. Objectives: To assess the Prevalence, risk factor, maternal and fetal outcome of placenta accrete spectrum at Saint Paul’s hospital millennium medical college. Methods: This was a five-year (2020-2025) retrospective review on risk factors, maternal and perinatal outcome of PAS managed at St. Paul’s Hospital Millennium Medical College. Data were collected retrospectively using electronic capture technique using open data kit (ODK). Data were analyzed using SPSS version 27 Simple descriptive statistics, Chi-Squared test, and multiple logistic regression analysis were performed as appropriate. Odds ration with 95% CI and P-value of <0.05 was used to present findings significance. Result: - Among the study participants, 67.4% of women experienced poor composite maternal outcomes. The most common maternal complications were PPH (67.4%), Need for ICU admission (67.4%), Maternal infection (16.3%), Organ injury (25.6%), and relaparatomy(9.3%). Grade of adherence(AOR = 7.28, 95% CI: 1.85–28.65, p=0.004) , and mode of delivery (AOR = 5.83, 95% CI:1.15–29.5, p=0.033) were significant predictors of adverse maternal outcomes. Poor perinatal outcomes occurred in 44.2% of neonates, with prematurity, low birth weight, and NICU admission being most frequent. Type of CD(AOR=4.92,95% CI: 1.08–22.42, p=0.039) and Grade of adherence (AOR =3.61, 95% CI: 1.02–12.85, p=0.046) were independently associated with adverse perinatal outcomes. Cesarean Hysterectomy was the most common mode of delivery (51.2%), followed by Cesarean section(46.5%). Conclusion: - The study revealed a high burden of adverse maternal and perinatal outcomes among the participants. Perinatal outcomes were also concerning, with 44.2% of neonates experiencing poor outcomes, predominantly prematurity, low birth weight, and NICU admission. Key factors associated with adverse perinatal outcomes were GA at delivery and birth weight. Keywords; PAS, maternal outcome, perinatal outcome, St Paul’s hospital millennium medical college