Correlation of Placenta Accreta Index with Maternal Outcomes in Patients with Morbidly Adherent Placenta

Objective: To assess the correlation of a novel scoring system, placenta accreta index with maternal outcomes in placenta accreta spectrum disorders. Study Design: Prospective longitudinal study Place and Duration of Study: Obstetrics and Gynecology Department of Combined Military Hospital Quetta, Pakistan from Apr 2022- Mar 2023. Methodology: A comparative study was carried out at Combined Military Hospital, Quetta after ethical approval. The study spanned over a year from April 2022 to March 2023. Thirty patients in second and third trimester of pregnancy with suspicion of placenta accreta on obstetric ultrasound were included in the study. The placenta accreta index (PAI) was calculated for all patients and morbidly adherent placenta categories were defined. The primary maternal outcome was cesarean hysterectomy.  Results: Cesarean hysterectomy was done in none of the low risk and medium risk patients and it was carried out in 11(84.6%) high risk patients with a p value of <0.001. Conclusion: Placenta accreta index (PAI) can reliably identify patients at high risk of having morbidly adherent placenta and adverse outcomes. This scoring system can assist obstetricians in timely counseling of patients, effective pre-operative planning and timely intervention to reduce maternal morbidity and mortality.