THE RELATIONSHIP OF PLACENTA ACCRETA SPECTRUM WITH PREVIOUS CESAREAN SECTION IN PATIENTS WITH PLACENTA PREVIA- A CASE-CONTROL STUDY IN TERTIARY CARE HOSPITAL OF PESHAWAR

Objective: To determine the relation of placenta Acreta Spectrum with previous Cesarean section in patients with placenta previa. Material and Methods: This case-control study was conducted in a tertiary care hospital in Peshawar from 1st July 2019 to 30th June 2021. All the cases with placenta Previa were included. Women with placenta Acreta Spectrum diagnosed on obstetric ultrasound served as cases. Patients with placenta previa without accrete served as controls. Their records were studied in detail and all the data was recorded in a Proforma specially designed for this study. Odds ratios at the end of the study were calculated using SPSS-23. Results: During our study period, a total of 102 patients with placenta previa were enrolled. The ages ranged between 20-45 years. The majority of the patients were > 40 years old (31.3%). On the basis of gravidity, different groups were found i.e. 45 patients (44.1 %) were between G5-G6. A total of 14 women were found with placenta accrete spectrum making an incidence of 13.72%. Of all the patients’ i.e.100% (odd ratio 1.1) were having a history of previous Cesarean birth. 6 out of 14 patients (42.8%) had a history of previous 1 Cesarean section while two patients (10%) had a history of 4 c\s in the past. Nearly all patients had major placenta previa except one patient who had minor placenta previa (7%). Conclusion: Our study highlighted the striking relationship of placenta Accreta spectrum with previous Cesarean delivery in patients with placenta previa however it was not found that increasing the number of previous Cesarean sections resulted in an increased number of placentae Accreta spectrum. Keywords: Placenta Accreta spectrum, Cesarean section.