Assessment of Fetomaternal Outcome in Females Presenting with Morbidly Adherent Placenta in a Large Tertiary Care Facility

Abstract

Objective: To assess fetomaternal outcome in females presenting with morbidly adherent placenta

Methodology: This descriptive study was conducted at Department of Obstetrics & Gynecology, Shifa International Hospital, Islamabad. A total of 50 females were recruited in 6-month period (5th November 2022 to 5th May 2023). Both booked and non-booked females were followed-up till delivery. Maternal outcome included hemorrhage, hysterectomy, preterm delivery and need of massive blood transfusion and ICU admission. Fetal outcome included birth weight, Apgar scores and NICU admissions. A structured proforma was used for data collection. Data analysis was performed in SPSS version 21.0.

Results: Mean age was 29.92 ± 6.59 years. There were 8 (16%) females with placenta increta, 4 (8%) had placenta percreta while 38 (76%) had placenta accreta. Antepartum hemorrhage was noted in 29 (58%) cases, hysterectomy was done in 25 (50%), preterm delivery in 28 (56%) cases, massive blood transfusion in 24 (48%), need for ICU care in 23 (46%) cases and need for neonatal care in 19 (38%) cases. Further analysis revealed that antepartum hemorrhage, need of ICU admission, low birth weight, and need of NICU admissions were more frequent in women with increta/percreta placental abruption, however, not statistically significant (p-value, 0.71).   

Conclusion: The maternal complications rate was very high in women with morbidly adherent placenta . Prematurity and need for neonatal intensive care unit were the most frequent fetal complications in this study.