Foeto-Maternal Outcome in Women with Placenta Praevia and Morbidly Adherent Placenta Praevia
Keywords:Antepartum, placenta accreta spectrum, placenta praevia, morbidly adherent placenta, postpartum haemorrhage.
Objective: To determine the maternal and foetal outcome in pregnant women with placenta praevia and morbidly adherent placenta praevia
Methodology: A prospective case series was carried out in a tertiary care institution between 2019 and 2021. All pregnant women with placenta praevia and placenta accreta spectrum who were over 28 weeks gestation were included, regardless of whether they received their diagnoses during pregnancy or during surgery. Data was collected on structured proforma regarding demographic characteristics, obstetric factors, management options, and intraoperative complications to determine foeto-maternal outcome in women with placenta praevia and morbidly adherent placenta praevia.
Results: Total number of patients with placenta praevia was 140; out of which 31 (22.1%) had placenta accreta spectrum. All cases of morbid adherence were found in major degree placenta praevia (p= 0.00). Antepartum haemorrhage in current pregnancy was more associated with placenta praevia as compared to morbidly adherent placenta praevia (p=0.00). Both placenta praevia with and without morbid adherence led to preterm birth (p=0.00). LSCS as mode of delivery in previous pregnancy, step-wise-devascularization, caesarean hysterectomies, bladder injury, blood loss more than 1000ml, number of blood transfusions, and mothers required ICU care were significantly associated (p≤0.05) with morbidly adherent placenta praevia as compare to placenta praevia without morbid adherence. In cases of placenta accreta spectrum; 11(33.3%) babies were admitted in NICU as compare to 29(25.9%) in placenta praevia without placenta accreta spectrum.
Conclusion: Placenta praevia is adversely affected by placenta accreta spectrum is associated with higher foeto-maternal morbidity as compared to placenta praevia without adherence.
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