Iranian Society of Gynecology Oncology

Document Type : Original Research Article


1 Student Research Committee, School of Medicine, Qom University of Medical Sciences, Qom, Iran

2 Assistant Professor of Pediatric Cardiology Department of Pediatrics, School of Medicine Hazrat-e Fateme Masoume Hospital Qom University of Medical Sciences

3 Department of Pediatrics, School of Medicine Hazrat-e Fateme Masoume Hospital Qom University of Medical Sciences

4 General Practitioner, Qom University of Medical Sciences, Qom

5 Assistant Professor of Obstetrics and Gynecology Department of Obstetrics and Gynecology, School of Medicine Qom University of Medical Sciences


Background: Placenta Accreta Spectrum is a condition in pregnant women where trophoblastic tissue attaches abnormally to the uterus myometrium, causing maternal deaths. Major risk factors include placenta previa and cesarean deliveries, which have been increasing without medical indication. This study aims to explore the risk factors of PAS, clinical outcomes, and strategies to minimize maternal morbidity and mortality.

Materials and Methods: A total of 142 women who had undergone at least one cesarean delivery in the past were included in our evaluation. Among them, 85 women had placenta accreta spectrum (PAS) in their current pregnancy (group 1) while the remaining 57 did not have PAS (group 2). We gathered information about their demographics and previous gynecological history, including placenta previa.

Results: The risk of placenta accreta spectrum (PAS) is significantly higher in cases where there has been a previous cesarean delivery or placenta previa (p-value<0.05). There were no significant differences between past elective or emergent CD (p-value>0.05). PAS was associated with more emergent cesarean deliveries (p-value<0.001) and hysterectomies (p-value<0.001). 97% of patients with history of placenta previa developed PAS (p-value<0.001). Most of the patients who underwent hysterectomy had PAS and placenta previa (p-value<0.001). There was no significant correlation found between previous hysteroscopies and curettages and a higher risk of PAS. (p-value>0.05)

Conclusion: Women with previous cesarean delivery are significantly at risk of placenta accreta in their future pregnancies. Pregnant women should avoid insisting on elective cesarean delivery without medical indication. Planned cesarean delivery could reduce the maternal complications


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