الفهرس 
MORBIDLY ADHERENT PLACENTAOnly 14 pages are availabe for public view
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Abstract
Background: Placenta accreta is a potentially life-threatening obstetric condition that requires a multidisciplinary approach to management. The incidence of placenta accreta has increased and seems to parallel the increasing cesarean delivery rate. Women at greatest risk of placenta accreta are those who have myometrial damage caused by a previous cesarean delivery with either an anterior or posterior placenta previa overlying the uterine scar.
Aim of the Work: To assess the accuracy of measurement of third trimester maternal serum Pregnancy Associated Plasma Protein A (PAPP-A) as a predictor of placenta previa accreta.
Patients and Methods: After ethical committee approval and informed consent from the patients, this prospective cohort diagnostic study was conducted at tertiary care hospital at Ain Shams University hospitals and performed on a total of 100 Pregnant women who underwent Elective C.S for placenta previa accreta starting from September 2017 till October 2021.
Results: Placenta accreta was found in 91% of the studied cases followed by placenta percreta (9%). PAPP-A level was significantly highest in cases with percreta, followed by placenta accreta with statistically significant difference between accreta and percreta.
Conclusion: It is the first study to assess the PAPP-A level in the third trimester for prediction of placenta previa accreta with prediction of intra and postoperative complications which represent a strength point of the study. Third trimester Maternal serum Pregnancy Associated Plasma protein A (PAPP-A) levels are significantly accurate in predicting pregnancies at high risk for placenta accreta and operative complications of hysterectomy, visceral injury and blood loss.