Comparative Management and Outcomes of Placenta Accreta Spectrum Disorders in Egypt and Saudi Arabia: A Bi-National Retrospective Study

Abstract

Background: The placenta accreta spectrum is a serious obstetric complication that carries high morbidity and mortality for the mother, often associated with previous cesarean deliveries and an increasing cesarean section rate. This study compares the management strategies and maternal outcomes of PAS in Egypt versus Saudi Arabia (KSA) by highlighting the differences in antenatal diagnosis, surgical approaches, and resource use.

Methods: This is a retrospective bi-national study conducted between August 2022 and June 2023, considering 200 women diagnosed with PAS, with 100 participants from Egyptian and 100 from KSA. Data is collected from medical records concerning patient attributes, risk factors, antenatal diagnosis, management approaches, and maternal outcomes. For statistical analysis, SPSS 26 will be utilized, with the significant level at p ≤ 0.05.

Results: Demographic details were similar, including high rates of multiparity and previous cesareans. Antenatal ultrasound diagnosis was higher in KSA (71%) than Egypt (62%; p=0.03). Cesarean hysterectomy was prevalent (41% in Egypt vs. 36% in KSA); however, KSA employed advanced techniques such as cell salvage (18%) and interventional radiology (9%), which were not utilized in Egypt.  Egypt had a higher average blood loss (2100 mL vs. 1800 mL), which led to a higher transfusion rate (85% vs. 79%).  In Egypt, 24% of people who went to the ICU, and in KSA, 18% of people who went to the ICU.  There were no big differences between the PAS types.

Conclusion: Improved antenatal diagnosis and access to advanced interventions in KSA correlate with superior outcomes for mothers. Improved screening and resources within Egypt can likely reduce morbidity from PAS.