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Paving the Path to Prevent Peripartum Hysterectomies: Risk Stratification in Placenta Accreta Spectrum.
Ashmeet Kaur1, Kalpana Mangal1, Ankita Kumari Sharma1
1Department of Pathology, SMS Medical College, Jaipur, Rajasthan, India.
Journal of Mother and Child
|August 16, 2025
Summary
Placenta Accreta Spectrum (PAS) incidence is 0.94%, with multiparity and prior C-sections as key risks. A new risk model aids early detection to reduce maternal morbidity.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Reproductive Health
Background:
- Placenta Accreta Spectrum (PAS) is a severe obstetric complication with rising incidence.
- Increasing rates are linked to caesarean deliveries and assisted reproductive technologies.
Purpose of the Study:
- Determine PAS incidence in a specific population.
- Identify significant risk factors associated with PAS.
- Develop a clinically applicable risk stratification model for early PAS detection.
Main Methods:
- Retrospective analysis of 85 PAS cases from 9,088 deliveries.
- Inclusion of clinical and histopathological data.
- Exclusion of cases with spontaneous placental separation.
Main Results:
- PAS incidence was 0.94%.
- Key risk factors identified: multiparity (82.4%), prior caesarean sections (88.2%), placenta praevia (70.6%), uterine surgeries (21.17%), and IVF (7.1%).
- A novel PAS risk model was developed integrating clinical predictors and weighted scoring.
Conclusions:
- PAS presents a significant obstetric challenge requiring early detection.
- Established risk factors necessitate structured referral pathways to mitigate maternal morbidity.
- The study provides a tailored, evidence-based risk model for resource-limited settings, addressing a gap in global PAS data.
