Kaur Ashmeet, Mangal Kalpana, Sharma Ankita Kumari, Gupta Mahi, Bansal Aditi, Yadav Pritosh
Department of Pathology, SMS Medical College, Jaipur, Rajasthan, India.
Department of Pathology, Geetanjali Medical College and Hospital, Udaipur, India.
J Mother Child. 2025 Aug 16;29(1):83-92. doi: 10.34763/jmotherandchild.20252901.d-25-00011. eCollection 2025 Feb 1.
Placenta Accreta Spectrum (PAS) is a life-threatening obstetric condition with increasing incidence due to rising caesarean deliveries and assisted reproductive technologies. Our objective was to determine PAS incidence, identify risk factors, and develop a clinically relevant risk stratification model.
A retrospective study of 85 PAS cases from 9,088 deliveries (September 2023 to September 2024, SMS Medical College, Jaipur) analysed clinical and histopathological data, including placenta praevia, multiparity, prior caesarean sections, uterine surgeries, and IVF. Cases with spontaneous placental separation were excluded.
PAS incidence was 0.94%. Placenta accreta, increta, and percreta were found in 35.3%, 34.1%, and 30.6% of cases, respectively. Significant risk factors included multiparity (82.4%, p < 0.001), prior caesarean sections (88.2%, p < 0.05), placenta praevia (70.6%, p = 0.002), uterine surgeries (21.17%, p < 0.05), and IVF (7.1%, p < 0.05). A PAS risk model integrating clinical predictors and region-specific weighted scoring was developed for early identification.
PAS is a significant obstetric challenge. Identified risk factors include multiparity, prior caesarean sections, placenta praevia, uterine surgeries, and IVF. Early detection and structured referral pathways are critical for reducing maternal morbidity. This study bridges the gap between region-specific data and global PAS trends, offering a tailored, evidence-based risk stratification model for improved maternal care in resource-limited settings.
胎盘植入谱系疾病（PAS）是一种危及生命的产科疾病，由于剖宫产率上升和辅助生殖技术的应用，其发病率不断增加。我们的目标是确定PAS的发病率，识别危险因素，并建立一个具有临床相关性的风险分层模型。
对斋浦尔SMS医学院2023年9月至2024年9月期间9088例分娩中的85例PAS病例进行回顾性研究，分析临床和组织病理学数据，包括前置胎盘、多胎妊娠、既往剖宫产史、子宫手术史和体外受精史。排除胎盘自然剥离的病例。
PAS发病率为0.94%。胎盘粘连、胎盘植入和穿透性胎盘植入分别占病例的35.3%、34.1%和30.6%。显著的危险因素包括多胎妊娠（82.4%，p<0.001）、既往剖宫产史（88.2%，p<0.05）、前置胎盘（70.6%，p=0.002）、子宫手术史（21.17%，p<0.05）和体外受精史（7.1%，p<0.05）。为早期识别建立了一个整合临床预测因素和区域特异性加权评分的PAS风险模型。
PAS是一项重大的产科挑战。已识别的危险因素包括多胎妊娠、既往剖宫产史、前置胎盘、子宫手术史和体外受精史。早期检测和结构化转诊途径对于降低孕产妇发病率至关重要。本研究填补了区域特异性数据与全球PAS趋势之间的空白，提供了一个量身定制的、基于证据的风险分层模型，以改善资源有限环境下的孕产妇护理。
