Placenta Accreta Spectrum in delivered women is associated with history of curettage: A case-control study at Dr. Moewardi General Hospital, Surakarta, Indonesia

HIGHLIGHTS

1. Placenta Accreta Spectrum cases rise in proportion to the high frequency of uterine wall damage.
2. A significant association was found between curettage history and Placenta Accreta Spectrum.

ABSTRACT

Objective: Placenta Accreta Spectrum (PAS) is a condition in which the placental villi directly adhere to the myometrium, a leading cause of serious obstetric bleeding. The situation has increased morbidity and mortality in pregnant women due to 3.000 – 5.000 mL blood loss. The incidence of PAS has risen globally from 0.12% to 0.31%, linked to frequent uterine damage from procedures like cesarean sections or curettage. This study aims to determine the association between history of curettage and PAS.

Materials and Methods: The type of research used is analytic observational with a case-control approach. The sampling technique used in this study is purposive sampling, and 134 samples match the inclusion criteria. The samples used are delivered women referred to Dr. Moewardi General Hospital, Surakarta, Indonesia, from May 2022 until May 2024. Data analysis utilizing IBM SPSS 25. Chi-square test determines the association between two variables at a significance level of p < 0.05, while logistic regression is used to determine the most influential variables.

Results: The sample consisted of 67 patients with PAS and 67 without PAS. There was a significant association between the history of curettage and PAS, as determined by a Chi-square test, with a p-value of 0.000. Further analysis using logistic regression on the history of curettage obtained a value of p = 0.001 and OR = 5.769 (CI95% 2.090 – 15.928).

Conclusion: The history of curettage is significantly associated with PAS. Patients who have had curettage in the past are 5.769 times more likely to experience PAS than patients without a history of curettage.