Endometrial Cavity After Conservative Management of PAS Patients by Hysteroscopy

Evaluation of Endometrial Cavity After Conservative Management of PAS Patients by Hysteroscopy

This study aimed to evaluate the endometrial cavity by hysteroscopy after different conservative management of placenta accrete spectrum (PAS), that has impact on the future fertility outcome and menstrual pattern of patients.

Placenta Accreta Spectrum is usually associated with maternal morbidity and mortality. The morbidly adherent placenta spectrum includes, placenta accreta when the placenta invades the endometrium beyond Nitabuch's layer of decidua basalis, placenta increta when the placenta invades the myometrium, and placenta percreta when the placenta invades the uterine serosa.

The risk factors of PAS include previous caesarean section (CS), previous myomectomy, placenta previa, and damage of Nitabuch's layer following intrauterine infection and/or endometrial curettage.

Inclusion Criteria:

• Age from 20 to 40 years.
• Pregnant women more than 28 weeks have a desire to preserve future fertility.
• Diagnosis of Placenta accreta spectrum (PAS) was evaluated by 2 D grey scale ultrasound and Doppler study of invasion of the placenta.
• History of at least previous caesarean section (CS) or any intrauterine operation like myomectomy.
• Females with history of different conservatives management methods of PAS in last three months.

Exclusion Criteria:

• Non placenta accreta spectrum and primigravida.
• Those who have congenital anomalies in the uterus.
• Those with bleeding tendency.
• Those women that had hysterectomy as a radical surgery.