Mortality and Adverse Outcomes in Patients of Morbidly Adherent Placenta

Attia  Rabbani; Aysha  Khudija; Heema  .; Saira  Ghafoor; Shazia  Aftab; Nazish  Ali

doi:10.29054/apmc/2019.42

Attia Rabbani Consultant Gynecologist, Govt. Children Hospital, Multan
Aysha Khudija Consultant Gynaecologist, Govt. General Hospital Samanabad, Faisalabad
Heema . Assistant Professor, Department of Gynae and Obs, Liaqat Memorial Women and Children Teaching, KIMS, Kohat.
Saira Ghafoor Assistant Professor, Gynaecology Jinnah Medical and Dental College Hospital, Karachi
Shazia Aftab Associate Professor, Gynaecology Jinnah Medical and Dental College, Karachi
Nazish Ali Senior Registrar, Gynaecology, Jinnah Medical and Dental College Hospital, Karachi

DOI: https://doi.org/10.29054/apmc/2019.42

Keywords: Placenta, Death, ICU

Abstract

Objective: To determine the mortality and adverse outcomes in cases presenting with morbidly adherent placenta presenting to a tertiary care hospital. Study design: This was a cross sectional study. Settings: District Headquarter Hospital Rawalpindi. Duration: 01-06-2015 to 30-11-2015. Methodology: The females between the age of 20 to 40 years, delivering at the same institute with morbidly adherent placenta were selected. The diagnosis of MAP was made on the basis of clinical or histo-pathological examination. These cases then underwent with hysterectomy and were looked for bladder injury, blood loss, ICU admission or maternal death. Results: In the present study 40 cases of morbidly adherent placenta were included. the mean age of the subjects was 33.58±6.34 years. The mean parity was 2.1±0.98 and 54% of the cases had a prior C section and only 18% of the cases had a regular ante natal follow up. After the surgery bladder injury was seen in 10%, ICU admission in 32.50% of the cases and mortality in 30% of the cases while average blood loss was 2.8±0.78 litres. Conclusion: Morbidly adherent placenta is a highly morbid condition where it can be fatal in almost 1/3^rd of the cases.