Journal Article

Risk factors for placenta accreta spectrum disorders in women with any prior cesarean and a placenta previa or low lying: a prospective population-based study

Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Sentilhes, Loïc, CHU Rouen ; Normandie Université (NU), Bonnet, Marie, Pierre, Hôpital Louis Mourier - AP-HP [Colombes] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHI Poissy-Saint-Germain, Centre Hospitalier Universitaire de Bordeaux (CHU Bordeaux), Huissoud, Cyril, Centre Hospitalier Universitaire [Strasbourg] (CHU Strasbourg) ; Hôpitaux Universitaires de Strasbourg (HUS), Dupont, Corinne, Deneux-Tharaux, Catherine, Rozenberg, Patrick, Hôpital de la Croix-Rousse [CHU - HCL] ; Hospices Civils de Lyon (HCL), Physiopathologie des Adaptations Nutritionnelles (PhAN) ; Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE) ; Nantes Université - pôle Santé ; Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé ; Nantes Université (Nantes Univ)-Nantes Université (Nante

2024

Overview

This study aimed to identify the risk factors for placenta accreta spectrum (PAS) in women who had at least one previous cesarean delivery and a placenta previa or low-lying. The PACCRETA prospective population-based study took place in 12 regional perinatal networks from 2013 through 2015. All women with one or more prior cesareans and a placenta previa or low lying were included. Placenta accreta spectrum (PAS) was diagnosed at delivery according to standardized clinical and histological criteria. Of the 520,114 deliveries, 396 fulfilled inclusion criteria; 108 were classified with PAS at delivery. Combining the number of prior cesareans and the placental location yielded a rate ranging from 5% for one prior cesarean combined with a posterior low-lying placenta to 63% for three or more prior cesareans combined with placenta previa. The factors independently associated with PAS disorders were BMI ≥ 30, previous uterine surgery, previous postpartum hemorrhage, a higher number of prior cesareans, and a placenta previa. Finally, in this high-risk population, the rate of PAS disorders varies greatly, not only with the number of prior cesareans but also with the exact placental location and some of the women's individual characteristics. Risk stratification is thus possible in this population.

• Publisher: Nature Publishing Group,CCSD,Nature Publishing Group UK,Nature Portfolio
• Subject: 692/308 / 692/308/174 / Cesarean section / Cesarean Section - adverse effects / Female / Gynecology and obstetrics / Hemorrhage / Human health and pathology / Humanities and Social Sciences / Humans / Life Sciences / multidisciplinary / Placenta / Placenta Accreta - epidemiology / Placenta Accreta - etiology / Placenta Previa - epidemiology / Placenta Previa - etiology / Population studies / Population-based studies / Pregnancy / Pregnancy complications / Prospective Studies / Retrospective Studies / Risk Factors / Santé publique et épidémiologie / Science / Science (multidisciplinary)
• ISBN: 0011882765001