Clinical profiles of placenta accreta spectrum: the PACCRETA population‐based study

Objective To describe and compare the characteristics of women with placenta accreta spectrum (PAS) and their pregnancy outcomes according to the presence of placenta praevia and a prior caesarean section. Design Prospective population‐based study. Setting All 176 maternity hospitals of eight French regions. Population Two hundred and forty‐nine women with PAS, from a source population of 520 114 deliveries. Methods Women with PAS were classified into two risk‐profile groups, with or without the high‐risk combination of placenta praevia (or an anterior low‐lying placenta) and at least one prior caesarean. These two groups were described and compared. Main outcome measures Population‐based incidence of PAS, characteristics of women, pregnancies, deliveries and pregnancy outcomes. Results The PAS population‐based incidence was 4.8/10 000 (95% CI 4.2–5.4/10 000). After exclusion of women lost to follow up from the analysis, the group with placenta praevia and a prior caesarean included 115 (48%) women and the group without this combination included 127 (52%). In the group with both factors, PAS was more often suspected antenatally (77% versus 17%; P