Placenta Accreta Spectrum Disorders: A Canadian Tertiary Care Centre's Experience Over 10 years

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine

Background:

• Placenta Accreta Spectrum Disorders (PASD) pose significant risks for maternal and neonatal health globally.
• Increasing cesarean delivery rates correlate with a rise in PASD incidence.

Purpose of the Study:

• To present a decade of institutional experience in the diagnosis and perioperative management of PASD.
• To share outcomes from a tertiary care center's approach to managing these complex cases.

Main Methods:

• Retrospective review of cesarean hysterectomies for suspected or confirmed PASD.
• Data collected from a single tertiary care center in Canada between 2010 and 2021.

Main Results:

• Of 46 cases, 94% had PASD (20% accreta, 48% increta, 26% percreta).
• 41% of cesarean hysterectomies were emergencies; 50% required intraoperative blood transfusion.
• Ureteric injury occurred in 2% of cases, with 13% requiring ICU admission.

Conclusions:

• PASD is a challenging condition with high morbidity.
• Institutional experience highlights variations in practice, such as prophylactic ureteric stenting.
• Further research is essential for optimizing PASD diagnosis and management strategies.