Clinical Spectrum, Surgical Challenges, and Maternal Outcomes in Placenta Accreta Spectrum: A Case Series from a Tertiary Care Center

Abstract

Placenta accreta spectrum (PAS) represents a significant challenge in obstetric care, characterized by abnormal placental invasion or adherence to the uterine wall. The incidence of PAS has increased with the rising rates of cesarean sections, and it is associated with severe maternal morbidity and mortality. This case series presents the clinical spectrum, surgical challenges, and maternal outcomes of nine cases of PAS managed at a tertiary care center. The cases varied from focal accreta to severe placenta percreta, with complications such as massive hemorrhage, multiorgan dysfunction, and the need for peripartum hysterectomy. The findings emphasize the importance of early antenatal diagnosis using ultrasound and MRI to improve maternal outcomes. The study highlights that while antenatal diagnosis facilitates better management, emergency presentations, particularly in unbooked cases, continue to pose significant risks. Postoperative complications included hypovolemic shock, kidney injury, and pulmonary edema, necessitating intensive care and transfusion support. Despite these challenges, early detection and timely intervention significantly improve survival rates for both mothers and neonates.