Placenta Accreta Spectrum Outcome After Uterine Conservation

After institutional review board approval and written informed consent, recruited cases will be subjected to the following:

• Data registration including:

• Age.
• Obstetric history including gravidity, parity, number of previous cesarean deliveries, and number and gender of living children.
• Details of the current pregnancy including duration in menstrual weeks, any problems encountered during its course.
• Desire for future fertility.
• Medical, surgical, and medication history.
• Anthropometry including weight, height, and body mass index (BMI) before pregnancy and at the time of operation.
• General examination including vital signs, and signs of any associated problems.
• Routine laboratory investigations with particular emphasis on complete blood count, Coagulation profile and including blood glucose level, renal and liver function tests.
• Detailed sonographic examination to evaluate fetal biometry, and wellbeing rule out exclusion factors, and confirm diagnosis of PAS and assess the degree of invasion, and its severity using both trans-abdominal transducer with frequency of 2-5 megahertz (MHZ) and trans-vaginal transducer with frequency of 4-10 MHZ.

Intraoperative details will be documented. Follow up of patients will be recorded. Sample size was calculated by estimating a single proportion distribution at a significance level of 0.05.

Inclusion criteria

• • Diagnosed sonographically to have placenta accreta spectrum.

• Pregnancy is singleton and fetus is alive.
• Elective caesarean section done from 35 gestational weeks.

Exclusion criteria

• • Patients requesting hysterectomy.

• Coexisting uterine pathology such as fibroids or gynaecological malignancies.
• Patients with bleeding diathesis.
• Morbid obesity of BMI >40.
• Patients having labour pains or vaginal bleeding before scheduled intervention.