The New Indian Journal of OBGYN. Epub Ahead of Print

A case series: learning curve in managing placenta accreta spectrum at tertiary care centre

Amrita Chaurasia, Vandana Ojha, Dilip Chaurasia, Shweta, Yashi Srivastava, Sonal Tripathi

ABSTRACT

Background: Placenta accreta spectrum is a life threatening condition of abnormal invasion and adherence of placental villi to the myometrium. PAS is associated with very high maternal morbidity and mortality and requires a multidisciplinary approach with all the expertise to reduce adverse outcomes. Method: Here, we are discussing our learning curve to manage the PAS cases over 3 years (July 2018 to June 2021) in a Government Medical college of Uttar Pradesh, where though we have all kind of expertise but little limited availability of modern procedures. We have discussed the cases, mode of diagnosis, management and procedure done, intraoperative complications faced, management of the complications and postoperative prognosis of the patients. Result: We managed the patients based on the principals and with our limitations. We learned from our mistakes in every case. We also had formulated a customized SOP guided by the ACOG and as per our facility and past experiences for PAS management in emergency as well as electively. Conclusion: Placenta accreta syndrome is increasing as the rate of caesarean section is increased, so reducing primary caesarean section will be a determining factor in reducing PAS incidence such a rapid rise in PAS calls for enhancing the skills to identify and manage it at all the levels of health care system.