Maternal and neonatal outcomes in planned versus emergency cesarean delivery for placenta accreta spectrum: A multinational database study

Introduction Placenta accreta spectrum (PAS) is a condition often resulting in severe maternal morbidity. Scheduled delivery by an experienced team has been shown to improve outcomes; however, the benefits must be weighed against risk of iatrogenic prematurity. The aim this study investigate rates emergency seen for antenatally suspected PAS and compare outcomes 15 referral centers International Society (IS-PAS). Material methods Fifteen provided cases between 2008 2019. women included were divided into two groups according whether they had planned or cesarean delivery. Delivery was defined as “planned” when performed at time date suit team. All remaining classified “emergency”. Maternal characteristics neonatal compared gestation Results In all, 356 included. Of these, 239 (67%) underwent 117 (33%) Vaginal bleeding indication 41 (41%). There no significant differences terms blood loss, transfusion major morbidity deliveries. However, rate intensive therapy unit admission increased with (45% vs 33%, P = .02). Antepartum hemorrhage only independent predictor (aOR: 4.3, 95% confidence interval 2.4-7.7). Emergency due vaginal more frequent false-positive (antenatally but not confirmed delivery) milder grades (accreta/increta). infants experiencing any 25% 34+1 36+0 weeks 19% >36+0 weeks. Conclusions excellence did increase single greatest factor antenatal hemorrhage. When adequate expertise resources are available, defer factors pre-term birth until can considered fetal outcomes. Further studies needed fully.