Morbidly adherent placenta: A critical review

Abstract

Objective To evaluate the demographic profile, high risk factors, fetomaternal outcome and management options in morbidly adherent placenta (MAP). Study Design Retrospective analysis. Methodology Review of 20 case records of women with MAP during year 2001-2006. Results The mean age and parity of the women was 27.7 ± 4.2 years and 2.5 respectively. 70 % women had previous uterine scar, and similar number had placenta previa. 60 % women presented with antepartum hemorrhage and 20 % with retained placenta. 85 % womenunderwent hysterectomy with 5 % requiring internal iliac artery ligation, another 5 % partial cystectomy and 15 % bladder repair. Blood loss was between one and nine litres requiring an average of six units whole blood and 4 units FFP. There were six (30 %) maternal deaths. 55 % of the newborns were preterm and the perinatal mortality was 33.3 %. Conclusion Cesarean section and placenta previa are significant risk factors. MAP is associated with high fetomaternal morbidity and mortality. © 2012 Federation of Obstetric & Gynecological Societies of India.