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Original Research 
RMJ. 2025; 50(3): 651-655


A retrospective estimation of Maternal Postoperative Morbidity Index and Comprehensive complication index in placenta accreta spectrum

Wajeha Najeeb, Tehreem Zahra, Iffat Noor, Sundas Khurshid Kiani.


Abstract
Objective: To identify risk factors, maternal outcomes, postoperative morbidity and complications assessment of placenta accreta spectrum.
Methodology: This retrospective cross-sectional study reviewed the hospital records of patients with placenta accreta spectrum (PAS) at Combined Military Hospital, Kharian, from January 2022 to December 2024. Primary outcome included Postoperative Morbidity Index (PMI) and the Comprehensive Complication Index (CCI) for all patients, assessing the grades of surgical complications using the Clavien-Dindo Classification (CDC). Data were analyzed using SPSS version 25.
Results: This study analyzed 47 cases of PAS with mean age of 33.02±4.37 years, and mean gestational age of 34.93±1.61 weeks. 74.5% of PAS had placenta accreta, 19.1% percreta and 6.4% increta. Hysterectomy with bilateral internal iliac ligation was performed in 53.2% of cases. A significant risk factor was a previous cesarean section (76.6%) with no significant association between PAS types and risk factors (p=0.86). The average PMI score was 0.117, with scores of 0.134 for accreta, 0.11 for increta, and 0.053 for percreta. Most complications were classified as CDC grade 1, though variations among types were not statistically significant (p=0.07). The average CCI score was 8.7, with 42.5% of patients showing this score, while 27.5% had a score of 0, and 14.9% had a score of 22.6.
Conclusion: Previous cesarean sections raised the risk of placenta accreta spectrum. The PMI and CCI scores indicated mild postoperative morbidity and complications.

Key words: Placenta accreta, Postoperative Morbidity Index, Comprehensive Complication Index, Clavien-Dindo Classification.


 
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How to Cite this Article
Pubmed Style

Najeeb W, Zahra T, Noor I, Kiani SK. A retrospective estimation of Maternal Postoperative Morbidity Index and Comprehensive complication index in placenta accreta spectrum. RMJ. 2025; 50(3): 651-655.

Web Style

Najeeb W, Zahra T, Noor I, Kiani SK. A retrospective estimation of Maternal Postoperative Morbidity Index and Comprehensive complication index in placenta accreta spectrum. https://www.rmj.org.pk/?mno=256651 [Access: October 30, 2025].

AMA (American Medical Association) Style

Najeeb W, Zahra T, Noor I, Kiani SK. A retrospective estimation of Maternal Postoperative Morbidity Index and Comprehensive complication index in placenta accreta spectrum. RMJ. 2025; 50(3): 651-655.


Vancouver/ICMJE Style

Najeeb W, Zahra T, Noor I, Kiani SK. A retrospective estimation of Maternal Postoperative Morbidity Index and Comprehensive complication index in placenta accreta spectrum. RMJ. (2025), [cited October 30, 2025]; 50(3): 651-655.


Harvard Style

Najeeb, W., Zahra, . T., Noor, . I. & Kiani, . S. K. (2025) A retrospective estimation of Maternal Postoperative Morbidity Index and Comprehensive complication index in placenta accreta spectrum. RMJ, 50 (3), 651-655.


Turabian Style

Najeeb, Wajeha, Tehreem Zahra, Iffat Noor, and Sundas Khurshid Kiani. 2025. A retrospective estimation of Maternal Postoperative Morbidity Index and Comprehensive complication index in placenta accreta spectrum. Rawal Medical Journal, 50 (3), 651-655.


Chicago Style

Najeeb, Wajeha, Tehreem Zahra, Iffat Noor, and Sundas Khurshid Kiani. "A retrospective estimation of Maternal Postoperative Morbidity Index and Comprehensive complication index in placenta accreta spectrum." Rawal Medical Journal 50 (2025), 651-655.


MLA (The Modern Language Association) Style

Najeeb, Wajeha, Tehreem Zahra, Iffat Noor, and Sundas Khurshid Kiani. "A retrospective estimation of Maternal Postoperative Morbidity Index and Comprehensive complication index in placenta accreta spectrum." Rawal Medical Journal 50.3 (2025), 651-655. Print.


APA (American Psychological Association) Style

Najeeb, W., Zahra, . T., Noor, . I. & Kiani, . S. K. (2025) A retrospective estimation of Maternal Postoperative Morbidity Index and Comprehensive complication index in placenta accreta spectrum. Rawal Medical Journal, 50 (3), 651-655.


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