Placenta Accreta Spectrum Disorder; is the main pathology placental invasion?

Objective: Placenta accreta spectrum disorder(PAS) is a wide spectrum of disease defining adherence of placenta. In the literature, the definition of PAS it s still changing after new studies. Design: Despite the definition is still changing, the exact pathophysiology is not clear. Setting and population: Pathology reports of all patients who had undergone peripartum hysterectomy in Sanliurfa Training and Research Hospital with the diagnosis of PAS, were evaluated retrospectively. Methods: Diagnosis of PAS was made preoperatively according to the findings with sonography or MRI from May 2017 to September 2021. Main outcome measures: Pathology reports of hysterectomy specimens and comparison of pre and postoperative diagnosis of PAS were the main outcome measures. Results: A total of 45 cases of peripartum hysterectomy due to PAS were identified retrospectively during these four years from the hospital’s medical records. Only 17 of 45 patients who underwent hysterectomy with the diagnosis of placenta accreta spectrum were found to have a histopathological diagnosis that supported placental invasion. In 20 patients, the histopathological diagnosis was consistent with a normal placenta protruding from a uterine wall defect independent of placental invasion. Histopathological diagnosis was compatible with the normal placenta in 8 patients. Conclusion: Although PAS is defined as ‘anormal placentation’; in new studies myometrial defect and placental protrusion may be the main cause of PAS. Funding: None.