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Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 1

(111) Outcomes in Prenatally Suspected Focal Placenta Accreta

Thursday, January 30, 2025
10:30 AM – 12:30 PM  
Objective: Placenta Accreta Spectrum (PAS) is associated with increased maternal morbidity and mortality and is the leading cause of peripartum hysterectomy. Morbidity has been shown to correlate with PAS severity. The purpose of this study is to describe the outcomes in cases of prenatally suspected focal placenta accreta.

Study Design: This is a retrospective cohort study evaluating focal accreta cases between 2020-2024. Focal accreta was defined as less than 25 mm by the greatest dimension of invasion on magnetic resonance imaging, an established threshold for hysterectomy. Delivery and neonatal outcomes were evaluated for the entire group and then compared between patients who delivered at less than 37 weeks and at or greater than 37 weeks to evaluate optimal delivery timing. Prior to 2022, there was no standardized timing for delivery of these cases. In 2022, we standardized delivery of focal accreta to ≥37 weeks.

Results: Of 29 focal accreta cases, 14 (48%) delivered <37 weeks and 15 (52%) delivered ≥37 weeks. Twenty-one (72%) had postpartum hemorrhage (PPH), 8 (28%) received a transfusion. Twenty-one (72%) deliveries were scheduled. Six (21%) met FIGO clinical criteria for PAS. Hysterectomy was performed in 2 (7%) cases and 4 (14%) cases required oversewing of the placental bed. Pathology was negative in 25 (89%) patients.  Median APGARs at 1 minute were 8 (8-8); no neonate had a pH < 7; and median birthweight was 2910g (2780-3055g). Six (21%) infants were admitted to the NICU. When comparing patients delivering <37 weeks to those delivered ≥37 weeks, there were no differences in maternal outcomes. Neonatal length of stay was longer for those delivered <37 weeks (p=0.031) (Table).

Conclusion: Patients with prenatally suspected focal accreta had favorable delivery and neonatal outcomes. Delivery at 37 weeks can safely be considered in cases of focal placenta accreta.