Placenta accreta in Aba, south eastern, Nigeria

Placenta accreta is a rare and challenging complication of pregnancy associated with increased maternal morbidity and mortality, loss of reproductive organs and high demands on health resources. The objective of this study was to identify the incidence, demographic characteristics, and mode of treatment of patients with placenta accreta.

A prospective descriptive study of 11 cases of placenta accreta seen at Nigerian Christian Hospital Aba, Nigeria between January 2002 and December 2005.

The incidence of placenta accreta was 1 in 282 deliveries (0.35%). Median maternal age was 30 years, with a median parity of 3. The associated risk factors observed were: previous caesarean section(82%); placenta praevia (73%) and previous uterine curettage (54.5%). No antenatal diagnosis was achieved as all cases were either diagnosed at surgery or manual removal of placenta. The total estimated intra-operative blood loss for all the 11 cases was 24,500 mls, with a median of 2000 mls. The total number of units of blood transfused was 46 with a median of 4. Emergency hysterectomy was carried out in 72.7% of the patients. There was one maternal death (9%) and three perinatal deaths (27%).

Placenta accreta is a major cause of obstetric haemorrhage and loss of reproductive organ with a huge demand on our meager health resources. It should be considered a possibility in women with previous caesarean section and placenta praevia.