الفهرس 
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Abstract
This prospective descriptive case series study was carried out at Department of Obstetrics and Gynecology of Menoufia University Hospitals for 10 months.
The study cohort included all admitted pregnant women with the diagnosis of placenta previa accreta whether presenting with or without vaginal bleeding after 28 weeks’ gestation confirmed by ultrasound scan.
We excluded patients with antepartum hemorrhage due to placenta previa without suspicious ultrasonographic signs of placenta accreta, and pregnant women with gestational hypertension, preeclampsia and twins.
Full history had been taken and physical examination was done for all study cases.
In patients with heavy vaginal bleeding, an emergency cesarean section had been performed after resuscitation irrespective of gestational age, type of placenta previa or absence of fetal heart sound, while in those with major degree placenta previa and mild bleeding before term, the patient was admitted and managed expectantly.
In our study, planned elective cesarean sections by multidisciplinary team helped in lower the incidence of complications to (3%), compared to emergency cesarean sections which were accompanied with higher incidence of complications (46.15% of emergency cases).
Maternal complications had been shown significant statistical difference between the two studied groups (p value=0.013).
Conservative measures were successfully done to avoid hysterectomy in (47.5 %) of the cases, included uterine artery ligation in 40% of them, internal iliac artery ligation in 5% of the cases uterine packing in 30% of the cases.
The most common cause of post cesarean section exploration was bladder injury while the most common cause of maternal ICU admission (22.5%) was severe bleeding and bladder injury after placenta percreta cases. DIC not seen in our study.
Blood component therapy that had been transferred to the patients showed high significant results in patients who had done hysterectomy with p value= (0.001). However, no maternal mortalities occurred in the study, the most common cause of neonatal mortalities (12.5%) was RDS.
Fifteen (37.5%) babies reported to be admitted to ICU, the most common cause was neonatal jaundice, prematurity (RDS), while jaundice was the most common complication.
A major strength of our study is its prospective population‐based design, not relying on routinely coded data to a certain case, while Our study limitations were; small number size (40), and there was no control group for placenta accreta (previa without accreta(.