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Title: PREDICTING THE UNPREDICTABLE : CORRELATION OF ULTRASOUND AND HISTOPATHOLOGICAL SCORING SYSTEMS FOR PROGNOSIS OF PLACENTA ACCRETA SPECTRUM AND PREGNANCY OUTCOME
e-poster Number: EP 379
Category: Maternal and Fetal Health?
Author Name: Dr. Sujata Deo
Institute: King George's Medical University Lucknow Lucknow
Co-Author Name:
Abstract :
Introduction:
PAS involves abnormal placental adherence to the myometrium causing life threatening hemorrhage. Prenatal diagnosis via ultrasound, Doppler and MRI is vital with scoring systems enhancing diagnostic accuracy and pregnancy outcome.
Aim & Objectives:
To study the ultrasound and histopathological scoring system of placenta accreta spectrum and their correlation to predict prognosis in terms of pregnancy outcome
Material and method:
This Prospective observational study was conducted in department of Obstetrics and Gynaecology, King George?s Medical University, Lucknow from January 2023 to January 2024.Total 53 patients with USG Doppler/MRI diagnosis of PAS were enrolled and divided into four groups: Group 0-Without PAS (14 patients), Group 1-Placenta Accreta (25 patients), Group 2-Placenta Increta (14 patients), Group 3-Placenta Percreta (6 patients). All subjects underwent cesarean hysterectomy and after surgery sample was sent for histopathology and HPE grading was done as per FIGO.
Results:
In this study 31cases (58.4%) had history of one previous LSCS, 19(35.8%) patients had history of two LSCS,45.2% had history of dilatation and curettage. 8(15.1%) were diagnosed as PAS 0, 25(47.2%) as PAS I,14(26.4%) as PAS II and 6(11.3%) as PAS III respectively on USG. There were 5(9.43%) maternal deaths due to hemorrhagic shock, sepsis and DIC. On histopathological, Grade I(Placenta accrete) 27 (54.7%) ,Grade 2 (Placenta Accreta) 12 (11.3%) ,Grade 3 (Placenta Percreta) 2 (4.3 %) cases were found.
Conclusions:
This study concluded that preoperative USG assessment of placenta and severity assessment based on objective scoring system(PAS) was useful in assessing the severity of placenta accreta spectrum. Patients with PAS need multidisplinary approach team like an obstetrician, anesthesiologist, urologist, interventional radiologist, blood bank physician and should be managed at tertiary care Centre for better outcomes.
