MORBIDLY ADHERENT PLACENTA IN PATIENTS WITH PLACENTA PREVIA AND FETO-MATERNAL OUTCOMES

Abstract

Background: Morbidly Adherent Placenta (MAP) is characterized by the placenta's aberrant attachment to the uterus. It affects about 1 in 500 pregnancies and increases the risk of serious side effects, such as heavy bleeding after delivery, the need for a hysterectomy, and hospitalization in an intensive care unit. Those who have placenta previa, and especially those who have had a C-section delivery, are more at risk for developing MAP. Many Pakistani women with critical obstetric disorders go untreated because of a lack of knowledge and understanding of the importance of prenatal care. Many women either obtain their prenatal care at larger clinics or maternity homes, where the diagnosis is either made after the patient experiences significant bleeding or not at all, or they do not receive prenatal care at all.

Objective: To examine the prevalence of morbidly adherent placenta (MAP) and feto-maternal consequences in patients with placenta previa (PP).

Study design: A retrospective study

Place and Duration: This study was conducted in SESSI Landhi Hospital, Karachi Pakistan from November 2021 to November 2023.

Methodology: The study included information from postpartum women with placenta previa who had received an ultrasound diagnosis but varied in age, race, and ethnicity. The diagnosis of a morbidly adherent placenta was made after a thorough medical and physical evaluation of the patients, which included relevant tests like MRI and color Doppler ultrasonography. Medical indications were used to determine the most appropriate mode of cesarean delivery, which might be either an elective lower segment cesarean section (ElLSCS) or an emergency lower segment cesarean section (EmLSCS).

Result: A total of 50 patients were included in this research. The participants in this study had a mean gestational age of 34.79 weeks and an average age of 30.12 years. Out of all the cases, 48% had emergency C-sections, and 52% had elective ones. With type IV accounting for 54% of cases in this study, type III for 30% of the women, and type II for 16% of the cases, these were the most common types of placenta previa. In terms of maternal complications, antepartum hemorrhage (APH) occurred in 30% of patients, 40% of cases required cesarean hysterectomies, and no maternal deaths occurred. Fetal outcomes included low birth weight in 48% of babies and a 26% admission rate to the NICU.

Conclusion: In conclusion, placenta previa patients had a high frequency of morbidly adherent placenta, and this condition was clearly linked to poor feto-maternal outcomes.