Today, a low-lying placenta previa and a surgical history of at least one prior uterine surgery, primarily a caesarean delivery (CD), are present in more than 95% of women who have been prenatally diagnosed with PAS. Up to 6% of pregnant women have the combination of a low-lying anterior placenta and prior uterine surgery at their 12-week ultrasound examination due to the rapid rise in CD rates around the world and the high prevalence of prior gynecologic surgery (myomectomy, uterine adhesiolysis, and septal resection)
It is well established that ultrasound in the second and third trimesters can detect PAS symptoms.
Outcomes improved when cases were managed by a multidisciplinary team in tertiary medical facilities with the required education and experience. Even with the best planning, medical professionals, and resources, bleeding can occasionally be fatal. PAS is among the most difficult obstetric conditions to treat and require utmost preparation.
The best strategy to avoid PAS is to decrease the rate of primary caesarean sections and consider the possibility of vaginal birth following the first caesarean delivery (VBAC).
he uterus undergoes physiological involution to revert to its pre-pregnancy state during the first 6 to 8 weeks after delivery. Although this can be difficult and uncomfortable, particularly in patients who have had caesarean deliveries, are obese, or have uterine myomas, the involution process can be assessed by palpating the fundal height. Ultrasonography (US) has substantially improved the examination of the postpartum uterus.