Maternal Outcome in Morbidly Adherent Placenta in Obstetrics Patients
Objective: To determine the frequency and maternal outcome in morbidly adherent placenta in obstetrics patients.
Study design: Descriptive, cross-sectional study.
Setting and duration: Department of Obstetrics & Gynecology, Liaquat University Hospital Hyderabad, from October 2014 to March 2015.
Methodology: A total of 195 women with low lying placenta partially or completely covering the internal os were selected for this study. After taking detailed history then patients were subject to relevant investigations includes ultrasound pelvis, color flow doppler, and MRI if doppler is inconclusive.
Results: The mean age was 30.77±2.42 years and average gestational age was 34.64±2.53 weeks. There were 60.51% type IV placenta praevia and 39.49% type III placenta praevia. The frequency of morbidly adherent placenta in Obstetrics patients was observed in 89.74%. Regarding the maternal outcome of the morbidly adherent placenta, 63.1% of the patients had an obstetric hysterectomy, 11.3% required bladder repair, 40.5% shifted to ICU, 85.1% women need multiple transfusion and maternal mortality was observed in 17.4% patients.
Conclusion: The results of our study show that morbidity adherent placenta is a frequent problem associated with the previous caesarean section and placenta praevia. The most frequent maternal outcome of morbidly adherent placenta aremultiple transfusions and obstetric hysterectomy. To reduce the related morbidity and mortality, a national guideline should be developed regarding the organization of obstetric care, and timing of ultrasound doppler examination and management interventions in such cases