Psychological Outcomes Associated with Severe Placenta Accreta Spectrum Disorder with Cesarean Hysterectomy: A Retrospective Survey Study

This retrospective survey study assesses rates of postpartum depression (PPD) and postpartum post-traumatic stress disorder (PTSD) in patients with prior hysterectomy for severe placenta accreta spectrum. Half of the patients met the Edinburgh Postnatal Depression Scale threshold for PPD, and 35% met the Post-traumatic Stress Disorder Checklist-5 (PCL5) threshold for PTSD. Patients who underwent a delayed hysterectomy were more likely to report symptoms of PTSD (75% vs. 8%, p<0.01) and had higher median PCL-5 scores than an immediate hysterectomy (51 [IQR 16,61]) vs. 11 [IQR 2,21], p=0.01). Large prospective studies are needed to confirm these findings and determine standardized interventions for patients at high risk of psychological sequelae.