DEFINITIVE MANAGEMENT OF MORBIDLY ADHERENT PLACENTA: ANALYSIS OF MATERNAL OUTCOMES

Objective: To identify risk factors predisposing to morbidly adherent placenta and to study obstetric outcome in such patients. Study Design: Retrospective descriptive study. Place and Duration of Study: Department of Obstetrics and Gynaecology Military Hospital Rawalpindi, from Jan 2014 to Dec...

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Autores principales:	Naila Tahir, Muhammad Adil, Bushra Afzal, Sidra Kiani, Raza Kiani, Shahbaz Khan
Formato:	article
Lenguaje:	EN
Publicado:	Army Medical College Rawalpindi 2018
Materias:	accrete caesarean section increta morbidly adherent placenta Medicine R Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/7c13e369a5ee4088a6b6117e70e9fc32
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spelling	oai:doaj.org-article:7c13e369a5ee4088a6b6117e70e9fc322021-12-02T02:46:51ZDEFINITIVE MANAGEMENT OF MORBIDLY ADHERENT PLACENTA: ANALYSIS OF MATERNAL OUTCOMES0030-96482411-8842https://doaj.org/article/7c13e369a5ee4088a6b6117e70e9fc322018-10-01T00:00:00Zhttps://www.pafmj.org/index.php/PAFMJ/article/view/2282/1979https://doaj.org/toc/0030-9648https://doaj.org/toc/2411-8842Objective: To identify risk factors predisposing to morbidly adherent placenta and to study obstetric outcome in such patients. Study Design: Retrospective descriptive study. Place and Duration of Study: Department of Obstetrics and Gynaecology Military Hospital Rawalpindi, from Jan 2014 to Dec 2014. Material and Methods: A total of 54 patients with morbidly adherent placenta were studied retrospectively. Patient’s data including demographic data, previous obstetric history and outcome was collected from hospital records. Data was analyzed by using SPSS version 20. Results: The incidence of morbidly adherent placenta was 4.74 per 1000 deliveries. Mean age of patients was 33.33 ± 2.82 years with mean gestational age of 35.13 ± 0.91 weeks. All patients had history of prior caesarean section with 4 (7.40%) patients having four, 32 (59.25%) having three, 16 (29.62%) having two and 2 (3.70%) having one previous caesarean section. Associated placenta previa was present in 43 (79.62%) patients. Out of 54 patients 39 (72.22%) had placenta accreta, 11 (20.37%) had placenta percreta while 4 (7.4%) had placenta increta. Obstetric hysterectomy was done in 51 patients while in remaining 3 uterus was preserved. Out of these three, one died as a result of septicemia while methotrexate was started in remaining two cases. However an interval hysterectomy was performed in these two cases because of massive postpartum hemorrhage. Conclusion: Previous caesarean section and placenta previa are major risk factors for morbidly adherent placenta. Patient education, antenatal diagnosis with well planned surgical intervention and anticipation of blood loss are keys to successful management.Naila TahirMuhammad AdilBushra AfzalSidra KianiRaza KianiShahbaz KhanArmy Medical College Rawalpindiarticleaccretecaesarean sectionincretamorbidly adherent placentaMedicineRMedicine (General)R5-920ENPakistan Armed Forces Medical Journal, Vol 68, Iss 5, Pp 1156-1160 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	accrete caesarean section increta morbidly adherent placenta Medicine R Medicine (General) R5-920
spellingShingle	accrete caesarean section increta morbidly adherent placenta Medicine R Medicine (General) R5-920 Naila Tahir Muhammad Adil Bushra Afzal Sidra Kiani Raza Kiani Shahbaz Khan DEFINITIVE MANAGEMENT OF MORBIDLY ADHERENT PLACENTA: ANALYSIS OF MATERNAL OUTCOMES
description	Objective: To identify risk factors predisposing to morbidly adherent placenta and to study obstetric outcome in such patients. Study Design: Retrospective descriptive study. Place and Duration of Study: Department of Obstetrics and Gynaecology Military Hospital Rawalpindi, from Jan 2014 to Dec 2014. Material and Methods: A total of 54 patients with morbidly adherent placenta were studied retrospectively. Patient’s data including demographic data, previous obstetric history and outcome was collected from hospital records. Data was analyzed by using SPSS version 20. Results: The incidence of morbidly adherent placenta was 4.74 per 1000 deliveries. Mean age of patients was 33.33 ± 2.82 years with mean gestational age of 35.13 ± 0.91 weeks. All patients had history of prior caesarean section with 4 (7.40%) patients having four, 32 (59.25%) having three, 16 (29.62%) having two and 2 (3.70%) having one previous caesarean section. Associated placenta previa was present in 43 (79.62%) patients. Out of 54 patients 39 (72.22%) had placenta accreta, 11 (20.37%) had placenta percreta while 4 (7.4%) had placenta increta. Obstetric hysterectomy was done in 51 patients while in remaining 3 uterus was preserved. Out of these three, one died as a result of septicemia while methotrexate was started in remaining two cases. However an interval hysterectomy was performed in these two cases because of massive postpartum hemorrhage. Conclusion: Previous caesarean section and placenta previa are major risk factors for morbidly adherent placenta. Patient education, antenatal diagnosis with well planned surgical intervention and anticipation of blood loss are keys to successful management.
format	article
author	Naila Tahir Muhammad Adil Bushra Afzal Sidra Kiani Raza Kiani Shahbaz Khan
author_facet	Naila Tahir Muhammad Adil Bushra Afzal Sidra Kiani Raza Kiani Shahbaz Khan
author_sort	Naila Tahir
title	DEFINITIVE MANAGEMENT OF MORBIDLY ADHERENT PLACENTA: ANALYSIS OF MATERNAL OUTCOMES
title_short	DEFINITIVE MANAGEMENT OF MORBIDLY ADHERENT PLACENTA: ANALYSIS OF MATERNAL OUTCOMES
title_full	DEFINITIVE MANAGEMENT OF MORBIDLY ADHERENT PLACENTA: ANALYSIS OF MATERNAL OUTCOMES
title_fullStr	DEFINITIVE MANAGEMENT OF MORBIDLY ADHERENT PLACENTA: ANALYSIS OF MATERNAL OUTCOMES
title_full_unstemmed	DEFINITIVE MANAGEMENT OF MORBIDLY ADHERENT PLACENTA: ANALYSIS OF MATERNAL OUTCOMES
title_sort	definitive management of morbidly adherent placenta: analysis of maternal outcomes
publisher	Army Medical College Rawalpindi
publishDate	2018
url	https://doaj.org/article/7c13e369a5ee4088a6b6117e70e9fc32
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DEFINITIVE MANAGEMENT OF MORBIDLY ADHERENT PLACENTA: ANALYSIS OF MATERNAL OUTCOMES

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