Placenta previa and Placenta Accreta Spectrum (PAS): Obstetric risk factors and fetomaternal outcome at a Tertiary Care Hospital in Sialkot.

Abstract

Objective: To evaluate the obstetric risk factors associated with placenta previa and placenta accreta spectrum (PAS), and to assess fetomaternal outcomes among pregnant women presenting to a tertiary care hospital. Study Design: Retrospective Analytical Cohort study. Setting: Department of Obstetrics and Gynecology, Khawaja Muhammad Safdar Medical College / Allama Iqbal Memorial Teaching Hospital, Sialkot. Period: January 2024 to December 2024. Methods: All women presenting to the emergency department or outpatient clinic with a pre-operative or per-operative diagnosis of placenta previa or PAS were included. Diagnosis was established through transabdominal ultrasonography performed by a consultant radiologist. Demographic, obstetric, operative, and neonatal data were extracted from hospital records. Maternal outcomes included hemorrhage, transfusion requirements, hysterectomy, ICU admission, and mortality. Neonatal outcomes included birth weight, APGAR scores, NICU admission, and neonatal mortality. Data were analyzed using SPSS version 17. Results: A total of 48 women were included. The mean maternal age was 30 ± 3 years, and mean gestational age was 35.6 ± 3.9 weeks. Emergency cesarean section was performed in 64.6% of cases. Placenta accreta was diagnosed in 21 women (43.8%). Hysterectomy and maternal ICU admission were required in 41.7% of cases each. There were 2 maternal deaths and 7 neonatal deaths. Primary postpartum hemorrhage occurred in 52.1% of patients. Preterm delivery (<37 weeks) was observed in 50% of neonates, while 31.3% required NICU admission. Conclusion: Placenta previa and PAS are associated with significant maternal morbidity and adverse neonatal outcomes. Early diagnosis, vigilant antenatal monitoring, and timely multidisciplinary management are essential for optimizing fetomaternal outcomes.