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Etiopathogenesis and risk factors for placental accreta spectrum disorders

Humaira Ali1, Edwin Chandraharan2

  • 1St George's University Hospitals NHS Foundation Trust, Blackshaw Road, London, SW17 0QT, UK.

Best Practice & Research. Clinical Obstetrics & Gynaecology
|August 6, 2020
PubMed

Insights

Placenta accreta spectrum (PAS) disorders are rising, linked to cesarean sections and uterine surgeries. Early diagnosis of PAS is crucial for improving maternal and fetal outcomes.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine

Background:

  • Placenta accreta spectrum (PAS) disorders, including placenta accreta, increta, and percreta, pose significant risks for maternal morbidity and mortality globally.
  • The incidence of PAS is increasing, with rising rates of cesarean sections and other uterine surgeries implicated in its development.

Purpose of the Study:

  • To review the etiopathogenesis and risk factors of placenta accreta spectrum disorders.
  • To highlight the importance of early diagnosis for improving maternal and fetal outcomes.

Main Methods:

  • Literature review focusing on the incidence, risk factors, and diagnostic challenges of PAS.
  • Analysis of the relationship between cesarean section rates, uterine surgeries, and PAS development.

Main Results:

  • PAS incidence is rising, strongly correlated with the number of prior cesarean deliveries and uterine surgeries.
  • A significant proportion of PAS cases (one-half to two-thirds) remain undiagnosed prenatally.
  • Increased risk of maternal morbidity and mortality is associated with undiagnosed PAS.

Conclusions:

  • Understanding the etiopathogenesis and risk factors of PAS is essential for timely diagnosis.
  • Early diagnosis and planned delivery are critical for mitigating maternal and fetal complications associated with PAS.

Keywords:
Placenta accretaPlacenta accreta spectrumPlacenta incretaPlacenta percretaPrevious cesarean sectionUterine surgery

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