Efficacy of distal haemostasis during caesarean delivery in women with placenta accreta spectrum disorders.

PAS was observed in 30.8% of the placenta praevia cases, and in 93.3% was associated with the presence of a uterine scar. Women with the placenta praevia and PAS had a significantly higher number of past deliveries (р = .001). According to the FIGO classification, 53.8% of women with placenta praevia observed during the Cesarean had РА1 and 46.2% PA2. With regards to the PAS disorders observed in 30.8% of patients, 38.4% had PAS3, 34.7% PAS4, 18.3% PAS5 and 8.5% PAS6. The histology analysis showed normal placental attachment in 42.9% of the total number of study participants, placenta accreta in 28.2%, placenta increta in 16.7%, and placenta percreta in 12.2%. In Group 1, we performed the resection of uterine wall with the attached portion of the placenta in 13.5% of women, in Group 2 in 30.3% women, and in Group 3 in 50.6% women. There was a significant 4.8-fold reduction in the number of hysterectomies in Group 3 versus Group 2 (р = .043) and a 4.4-fold reduction in Group 2 versus Group 1 (р = .003). In Group 2, the volume of blood loss was 1.3-fold lower and in Group 3 1.5-fold lower than in Group 1. Conclusion: The techniques of compression distal haemostasis evaluated in this study in women with PAS are efficacious in the reduction of adverse maternal outcomes and should be used more widely in clinical practice.