Abstract

Objective: To identify risk factors, maternal outcomes, postoperative morbidity and complications assessment of placenta accreta spectrum.
Methodology: This retrospective cross-sectional study reviewed the hospital records of patients with placenta accreta spectrum (PAS) at Combined Military Hospital, Kharian, from January 2022 to December 2024. Primary outcome included Postoperative Morbidity Index (PMI) and the Comprehensive Complication Index (CCI) for all patients, assessing the grades of surgical complications using the Clavien-Dindo Classification (CDC). Data were analyzed using SPSS version 25.
Results: This study analyzed 47 cases of PAS with mean age of 33.02±4.37 years, and mean gestational age of 34.93±1.61 weeks. 74.5% of PAS had placenta accreta, 19.1% percreta and 6.4% increta. Hysterectomy with bilateral internal iliac ligation was performed in 53.2% of cases. A significant risk factor was a previous cesarean section (76.6%) with no significant association between PAS types and risk factors (p=0.86). The average PMI score was 0.117, with scores of 0.134 for accreta, 0.11 for increta, and 0.053 for percreta. Most complications were classified as CDC grade 1, though variations among types were not statistically significant (p=0.07). The average CCI score was 8.7, with 42.5% of patients showing this score, while 27.5% had a score of 0, and 14.9% had a score of 22.6.
Conclusion: Previous cesarean sections raised the risk of placenta accreta spectrum. The PMI and CCI scores indicated mild postoperative morbidity and complications.

Key words: Placenta accreta, Postoperative Morbidity Index, Comprehensive Complication Index, Clavien-Dindo Classification.