Table 1.
The table provides a detailed comparison of incidence rates, key risk factors and clinical outcomes between PAS and non-PAS cases
| S. No. | Category | Parameter | No. of PAS Cases | No. of PAS Cases (%) | No. of Non-PAS Cases | No. of Non-PAS Cases (%) | P-Value |
|---|---|---|---|---|---|---|---|
| 1. | Total cases | 9088 | 85 | 0.93% | 9003 | 0.53 | |
| 2. | Clinical presentation | Antenatal bleeding | 35 | 41.2% | 3707 | 41.1% | 0.06 |
| Postpartum haemorrhage | 15 | 17.6% | 1482 | 16.46% | 0.1 | ||
| Hypertension | 2 | 2.4% | 211 | 2.3% | 0.3 | ||
| Preterm labor | 4 | 4.7% | 317 | 3.5% | 0.25 | ||
| 3. | Risk factors | Multiparity | 70 | 82.4% | 5000 | 55.5% | 0.0001 |
| Previous caesarean sections | |||||||
| 1 Previous | 35 | 41.2% | 3500 | 38.9% | 0.05 | ||
| 2 Previous | 25 | 29.4% | 2000 | 22.2% | 0.0001 | ||
| 3 + Previous | 15 | 17.6% | 800 | 8.9% | 0.002 | ||
| Placenta praevia | 60 | 70.6% | 2000 | 22.2% | 0.002 | ||
| 4. | History of uterine Surgeries | Myomectomy | 10 | 11.8% | 500 | 5.6% | 0.005 |
| Other surgeries | 8 | 9.4% | 400 | 4.4% | 0.03 | ||
| 5. | History of IVF | Present | 6 | 7.1% | 200 | 2.2% | 0.05 |
| 6. | Ultrasound & doppler findings | Loss of retroplacental Zone | 50 | 58.8% | 1500 | 16.7% | 0.001 |
| Placental lacunae | 40 | 47.1% | 1200 | 13.3% | 0.002 | ||
| Hypervascularity on Doppler | 55 | 64.7% | 1800 | 20.0% | 0.0005 | ||
| 7. | Maternal Outcomes | ≥ 4 Units transfused | 30 | 35.3% | 3000 | 33.3% | 0.2 |
| Hysterectomy required | 40 | 47.1% | 50 | 0.6% | 0.0001 | ||
| ICU admission | 8 | 9.4% | 741 | 8.2% | 0.3 | ||
| Mortality | 1 | 1.2% | 105 | 1.16% | 0.5 | ||
| 8. | Neonatal Outcomes | Preterm Birth (< 37 weeks) | 60 | 70.6% | 4000 | 44.4% | 0.0008 |
| NICU Admission | 50 | 58.8% | 3500 | 38.9% | 0.0015 |
Figure 1.
Gross morphology of abnormal placentation. A. Placenta increta: Cross-section showing invasion of placental tissue into the myometrium. B. Placenta accreta: Cross-section demonstrating placental adherence to the myometrium without significant invasion. C. Placenta percreta: Cross-section revealing placental invasion through the uterine wall, potentially involving serosa or adjacent organs.
Figure 2.
Histological section showing placenta accreta with chorionic villi directly attached to the myometrium, lacking the intervening decidual layer (HE 10 ×).
Figure 3.
a. Histological section showing placenta increta with chorionic villi invading the myometrial tissue, indicating deeper penetration. (HE 40 ×) b. Histological section showing deep chorionic villi invasion of the myometrial tissue, which disrupts its architecture. (HE 40 ×).
Figure 4.
Histological section showing placenta percreta with chorionic villi invading through the entire thickness of the myometrium, reaching the uterine serosa. (HE 10 ×).
Figure 5.
Distribution of key risk factors in Placenta Accreta Spectrum (PAS) cases.
Figure 6.
Colour Doppler ultrasound images showing protrusion of placental tissues beyond the outer confines of the uterine myometrium, with thinning of the uterine serosa-bladder wall complex and increased vascularity between the serosa and the bladder.
Figure 7.
Proposed PAS risk model, with comprehensive scoring and risk categorisation system.