Morbidly Adherent Placenta in Patients with Placenta Previa and feto-Maternal Outcomes

Abstract

Objective: To determine the frequency of morbidly adherent placenta (MAP) in patients with placenta previa (PP), and feto-maternal outcomes at two health facilities.

Material and methods: This retrospective descriptive study was done at the gynecology and OBS departments of Azra Naheed Medical College Lahore and Rahbar Medical and Dental College RMDC Lahore. One year data form July 2021 to June 2022, of pregnant women of all ages, races, and ethnicities who have been diagnosed with placenta previa by ultrasound were enrolled. The patient's complete medical and physical examination, including relevant tests such as ultrasound with colour doppler and MRI, were recorded to diagnose a morbidly adherent placenta. A morbidly adherent placenta was considered positive as per operative findings. Obstetric and perinatal outcomes were recorded via the study proforma. The data was analyzed using SPSS version 26.

Results: A total of 36 patients diagnosed with placenta previa were studied; their average age was 30.14+5.36 years and their mean gestational age was 34.85+3.27 weeks. Most of the cases 52.8% had placenta previa type IV. Out of 36 cases of placenta previa, 36.1% had a morbidly adherent placenta, (19.4% accreta, 13.9% increta, and 2.8% percreta). Antepartum haemorrhage (APH) occurred in 31.4% of patients, a cesarean hysterectomy was done in 40.0% of the cases, and no maternal mortality was found. According to the fetal outcomes, 48.6% of the neonates were underweight and the NICU admission rate was 25.7%.

Conclusion: Morbidly adherent placenta was found to be extremely common in patients with placenta previa and appears to be associated with poor feto-maternal outcomes.