Maternal and Neonatal Outcomes of Morbidly Adherent Placenta in Ain-Shams University Maternity Hospital From 2012 to 2017 | ||||
| Evidence Based Women's Health Journal | ||||
| Article 4, Volume 12, Issue 1, February 2022, Page 22-35 PDF (1.52 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ebwhj.2019.17455.1025 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Ehab Salah Hussien Abd Elsalam  1; Ayman Abdelrazek Abouelnour2; Ahmad Muhammad Bahaaelden Ahmad2; Rasha Mahmoud Medhat abd elhady2
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| 1Faculty of Medicine Ain Shams University - Obstetrics and Gynecology | ||||
| 2Department of Obstetrics and Gynecology, Faculty of Medicine, Ain-Shams University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Morbidly adherent placenta (MAP) is now a significant obstetric challenge results in significant maternal morbidity and mortality (it is responsible for 7-10% of maternal mortality). The incidence of MAP have increased over the past few decades, this is mainly because of the increasing caesarean delivery rate. Risk factors for MAP include placenta previa, cesarean delivery, high maternal age and high parity. Aim: This study aimed to investigate patient characteristics and neonatal and maternal outcomes of placenta accreta in Ain-Shams from 2012 to 2017. Materials and Methods: This is a retrospective study which was carried out in Ain Shams University Maternity Hospital (a major tertiary referral hospital in Egypt) during the period from January 2012 to December 2017 (6 years), the archives of the hospital were examined for hospital records fulfilling the criteria of the study population during the study period. Results: The results revealed that morbidly adherent placenta was recorded during the studied period in 467 cases with an incidence of 6.6/1000 deliveries (0.66%). Also, cases with placenta accreta were 379 (81.2%) of the total MAP cases (the incidence of placenta accreta was 5.36/1000 of the total deliveries). The mean age of MAP patients was 31.7 ± 4.8 year. Regarding parity, only 9 cases were Primiparous, about half of them (226 cases, 48.4%) were P3:P4, 170 cases (36.4%) were P1:P2, 62 cases 13.3% were grand MP (>5). The majority of MAP cases (458 cases, 98.1%) had previous caesarean section (about two thirds of them 264 cases, 56.5% had 2-3 CSs). These results revealed that increasing maternal age, high parity, placenta previa and previous caesarean section were significant risk for MAP. Conclusion: Early antenatal diagnosis of morbidly adherent placenta through imaging (ultrasound colour Doppler and MRI) allows for multidisciplinary planning in an attempt to minimize potential maternal or neonatal morbidity and mortality. Also, proper counselling of patients regarding associated risks reduces maternal morbidity and mortality. | ||||
| Keywords | ||||
| Adherent placenta; neonatal outcomes | ||||
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