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Morbidly adherent placenta: a critical review.
Richa Aggarwal1, Amita Suneja, Neelam Bala Vaid
1Department of Obstetrics & Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, 110095 India ; KL-99, Kavi Nagar, Ghaziabad, UP 201002 India.
Journal of Obstetrics and Gynaecology of India
|February 2, 2013
Summary
Morbidly adherent placenta (MAP) is linked to high maternal and infant mortality. Previous uterine scars and placenta previa are key risk factors, necessitating careful management.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Reproductive Health
Background:
- Morbidly adherent placenta (MAP) presents significant challenges in obstetric care.
- Understanding risk factors and outcomes is crucial for improving patient management.
Purpose of the Study:
- To analyze the demographic characteristics of women with MAP.
- To identify high-risk factors associated with MAP.
- To evaluate fetomaternal outcomes and management strategies for MAP.
Main Methods:
- A retrospective analysis was conducted.
- Review of 20 case records of women diagnosed with MAP between 2001 and 2006.
Main Results:
- The average maternal age was 27.7 years, with a parity of 2.5.
- 70% of women had prior uterine scars and/or placenta previa.
- Significant complications included antepartum hemorrhage (60%), retained placenta (20%), and high rates of hysterectomy (85%).
- Average blood loss was substantial (1-9 liters), requiring extensive transfusion.
- Maternal mortality was 30%, with 55% preterm births and 33.3% perinatal mortality.
Conclusions:
- Cesarean delivery and placenta previa are identified as significant risk factors for MAP.
- MAP is associated with severe fetomaternal morbidity and mortality, underscoring the need for specialized care.
