Clinical Characteristics, Prenatal Diagnosis and Outcomes of Placenta Accreta Spectrum in Different Placental Locations: A Retrospective Cohort Study

Figures & data

Table 1 Baseline Characteristics in Three Groups

	Anterior	Posterior	Lateral Wall/Fundus	p value
	n=59	n=52	n=7
PAS suspected prenatally	51(86.4)	19(36.5)	4(57.1)	<0.001^a
Maternal Age	32.71±5.07	31.67±5.31	33.29±5.41	0.504
Prepregnancy BMI	22.40±3.57	21.58±2.73	19.54±2.47	0.057
Gravidity	4(3–5)	4(2–5)	3(2–5)	0.585
Gravidity>3	37(62.7)	27(51.9)	3(42.9)	0.393
Parity	1(1–2)	1(1–2)	2(1–2)	0.071
Parity>1	24(40.7)	13(25.0)	4(57.1)	0.084
Nulliparous women	2(3.4)	3(5.8)	0(0)	0.754
Multiple gestation	2(3.4)	8(15.4)	1(14.3)	0.054
In vitro fertilization	2(3.4)	3(5.8)	1(14.3)	0.367
Placenta previa	56(94.9)	40(76.9)	7(100)	0.013^a
Severity of invasion				<0.001^a
Noninvasive (accreta)	11(18.6)	33(63.5)	5(71.4)
Invasive (increta/percreta)	48(81.4)	19(36.5)	2(28.6)
Delivery mode				0.016^a
Vaginal/operative vaginal	0(0)	1(1.9)	0(0)
Planed CS	57(96.6)	42(80.8)	5(71.4)
Emergency CS	2(3.4)	9(17.3)	2(28.6)
Delivery gestational weeks	34.91±1.76	36.4±2.45	34.31±3.41	<0.001^a
Birth weight	2935.93±563.45	3134.88±655.79	2792.29±748.93	0.151
Prior cesarean-section or prior uterine surgeries	49(83.1)	37(71.2)	6(85.7)	0.282
Previous PAS	5(8.5)	8(15.4)	0(0)	0.421
Previous placenta previa	4(6.8)	3(5.8)	1(14.3)	0.565

Notes: Data are presented as mean±standard deviation or median (interquartile range) or n (percentage). ^aStatistically significant characteristics were compared between the anterior and posterior placenta groups. The results showed significant differences in all these characteristics.

Abbreviations: PAS, placenta accreta spectrum; BMI, body mass index; CS, cesarean section.

Table 2 Prenatal Diagnostic Rate Based on Placental Location and Severity of Invasion

	Suspected Prenatally	Unsuspected Prenatally
Anterior placenta+Noninvasive PAS	6(54.6)	5(45.5)
Anterior placenta+Invasive PAS	45(93.8)	3(6.2)
Posterior placenta+Noninvasive PAS	6(18.2)	27(81.8)
Posterior placenta+Invasive PAS	13(68.4)	6(31.6)
Lateral wall/fundus placenta+Noninvasive PAS	2(40.0)	3(60.0)
Lateral wall/fundus placenta+Invasive PAS	2(100)	0(0)

Notes: Data are presented as n (percentage). Noninvasive PAS: placenta accreta. Invasive PAS: placenta increta/percreta.

Abbreviation: PAS, placenta accreta spectrum.

Table 3 Perinatal Outcomes in Three Study Groups

	Anterior	Posterior	Lateral Wall/Fundus	p value
	n=59	n=52	n=7
Operating time	122.71±28.47	137.75±23.18	141.43±38.91	0.009^a
Abdominal aorta balloon block	17(28.8)	3(5.8)	2(28.6)	0.004^a
Abdominal and Pelvic organ injuries	4(6.8)	0(0)	0(0)	0.162
Bladder injury	3(5.1)	0(0)	0(0)	0.165
Vascular injury	1(1.7)	0(0)	0(0)	1.000
Intestinal injury	0(0)	0(0)	0(0)	NA
Estimated blood loss in 24h	1000(800–2500)	1500(863–2300)	800(700–2000)	0.408
RBC transfusion	200(0–1000)	600(0–1000)	0(0–1000)	0.483
Fresh-frozen plasma transfusion	0(0–600)	400(0–600)	0(0–600)	0.509
Cryoprecipitation	0(0–0)	0(0–0)	0(0–0)	NA
Platelet transfusion	0(0–0)	0(0–0)	0(0–0)	NA
ICU admission	4(6.8)	0(0)	0(0)	0.256
Length of stay after CS	8(7–9)	7(7–8)	7(7–9)	0.003^a

Note: Data are presented as median (interquartile range) or n (percentage). ^aStatistically significant characteristics were compared between the anterior and posterior placenta groups. The results showed significant differences in all these characteristics.

Abbreviations: RBC, red blood cell; ICU, intensive care unit; CS, cesarean section; NA, not available.

Data Sharing Statement

The dataset used and/or analyzed during the current study is available from the corresponding authors upon reasonable request.