الفهرس 
ACKNOWLEDGEMENTSOnly 14 pages are availabe for public view
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Abstract
There has been a worldwide increase in the incidence of PAS related to increase of caesarean section rates,(4) Placenta accreta spectrum is associated with acute maternal morbidity and mortality And long-term complications (6).
Medical service no longer one sided evaluated. Patient centered care is a core in medical service. QOL and HS are important categories of patient-reported outcomes (PROs), (48) That can be used to assess the impact of current HS and to assess the efficiency of interventions Since health care is becoming more and more patient centered, Therefore, research on QOL and HS in postpartum women is increasing, in which multiple contributing factors and interventions are examined (57).
QoL was measured using the WHOQOL-Bref questionnaire.. It contains 26 items, divided into four domains (physical health, psychological health, social relationships, and environment) (9).
The 36-Item Short Form Health Survey (SF-36) was used to determine HS through eight domains (physical functioning (PF), role limitation due to physical problem (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role limitation due to emotional problem (RE), mental health (MH) (10).
This study is cross- sectional study conducted at women health hospital, Assiut university from 2021 to 2022, aims to evaluate health status and quality of life using two validated questionnaires the Short-Form Health Survey (SF-36) and WHOQOL-BREF survey in pregnant women complicated by placenta accreta spectrum.
Women with a history of a pregnancy complicated by PAS were invited to participate in a survey questionnaire, Two Arabic forms of validated surveys were completed: Short Form 36 (SF- 36) and The WHOQOL-Bref. (Appendix 2-3) (75-78).
The inclusion criteria were pregnancy complicated by PAS, and to provide informed consent and age over 18 years. Women who had previously agreed to be contacted for research involving PAS were invited to participate in this study. Women who responded to the invitation were asked to complete the two questionnaires, .Consent was obtained as part of the survey. .
After 6-8 weeks and 12 months postpartum a copy of WHOQOL-BREF scoring and SF-36 validated survey had fulfilled by patients.
SF- 36 consists of eight health domains. Scores range from 0 to 100, with higher scores indicating better health state (10).
The WHOQOL-Bref questionnaire was used to assess QOL produces a quality of life profile using four domain scores, the four domain scores denote an individual’s perception of quality of life in each particular domain. Domain scores are scaled in a positive direction (i.e. higher scores denote higher quality of life). The mean scores were calculated and were compared between women by pregnancy outcomes (9).
In our study, In SF-36 scoring physical and mental health domains affected almost equally and both have significant improvement after 1 year follow up, In WHOQOL-BREF scoring the lowest scores were on the social relationship domain (10.5%) followed by psychological health (19.7%), Environmental health (22.9%) then Physical health (25.7%).
This study found that for women who had a pregnancy complicated by PAS all physical and mental health domains in SF-36 and WHOQOL-BBRE domains are higher in the long term compared to puerperium. During follow up, there was significant improvement in all parameters of WHOQOL scoring and short form-36 domains in comparison to baseline data.
Mental and physical health domains scores were no different for any of the clinical scenarios analyzed here, except for significantly higher vitality and general health and significantly lower bodily pain among those women without bladder injury with 1 year follow up patients with bladder injury had significantly lower social function and significantly higher RLP, RLE and bodily pain.
patients who were admitted to ICU had significantly higher RLP and significantly lower physical health, vitality and general health in SF-36 domains, Also patients who were admitted to ICU had significantly lower physical health in WHOQOL-BREF domains, by 1 year follow up the differences between the groups had resolved, Other domains showed no significant differences between both groups of patients based on ICU’s admission.