Fertility status after placenta previa accreata spectrum

Objective: Evaluation of fertility status after placenta previa accreta spectrum. Method: This study was conducted between 01.01.2010 and 31.12.2022 at Dicle University, Faculty of Medicine, Department of Obstetrics and Gynecology. Among the patients with a history of cesarean section, placenta previa was diagnosed by transvaginal ultrasonography. Patients who 159 patients in whom placenta accreta spectrum was detected during cesarean section and uterine hemostatic sutures were applied were included. For data, patients were contacted by phone and the hospital database was retrospectively scanned. SPSS 22 package program was used for the analysis of the data. Results: It was determined that there were a total of 13878 births in our clinic during the 12-year period, 2591 of these births (19%) were vaginal births and 11287 (81%) were cesarean sections. it was determined that 725 (5%) of these births consisted of pregnant women diagnosed with placenta previa, with or without a history of cesarean section before diagnosis; Among them, 202 (1%) were determined to be patients diagnosed with placenta previa accreta spectrum. 41 out of 202 patients could not be reached, 2 patients did not want to participate in the study; Therefore, our study was conducted on 159 patients. Among the 159 patients included in our study, 57 patients had one, 61 patients had two, 32 patients had three, 8 patients had four, and 1 patient had five previous cesarean sections. While the pregnancy rate was 27% among the 159 patients included in our study, when the patients who did not want pregnancy and were protected were excluded, the pregnancy rate was found to be 65.1% among the remaining 66 patients. When the patients in whom pregnancy did not occur were examined, 80.2% were protected and 19.8% could not become pregnant despite not being protected. It was observed that placenta previa accreta recurred in 5 of the patients who became pregnant (11.6%). Conclusion: In our study, no significant difference was found in terms of pregnancy, placenta previa accreta recurrence rate, transfusion need, and menstrual pattern in patients who underwent uterine-sparing surgery and a bleeding-stopping suture was placed on the uterus. For this reason, we think that hemostatic sutures applied to the uterus during cesarean section do not have negative effects on fertility.