TITLE:
Maternal Outcome of Cases of Placenta Previa with and without Morbidly Adherent Placenta at King Abdul-Aziz University Hospital, Saudi Arabia
AUTHORS:
Ashraf Radwan, Abdel Magid Abdou, Sausan Kafy, Mamdouh Sheba, Hassan Allam, Moaz Bokhari, Majed Almutairi
KEYWORDS:
Maternal Outcomes, Placenta Previa, With and without Adherent Placenta
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.13,
November
12,
2018
ABSTRACT: Introduction:Worldwide increasing cesarean section rates are
expected to have a parallel increase in the number of cases of Placenta Previa
with all the expected complications, including pathologically adherent
placenta. This morbidly adherent placenta constitutes a serious and possibly a
life threatening complication. An efficient team capable for managing possible
complicated situations will be able to reduce mortality and morbidity. Objectives: The aim of our
study was to evaluate maternal outcome in cases of Placenta Previa with and
without morbidly adherent placenta. Methods: Analysis of all pregnancies complicated by antepartum
hemorrhage during the period from January 2013 to September 2017 at King
Abdul-Aziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia (KSA)
was done. Cases of Placenta Previa with gestational age > 28
weeks were included. They were classified into 2 groups; Group (A) included
Placenta Previa cases without morbidly adherent placenta and Group (B) included
cases with morbidly adherent placenta. Maternal
outcomes were recorded. Results: Placenta Previa was the leading cause of antepartum
hemorrhage constituting 76.8%, out of them 52% were unbooked. Morbidly adherent
placenta constituted 13.5% of total Placenta Previa cases and was diagnosed
prenatally in only 1 case. Morbidity rate in placenta previa patients with adherent placenta (Group
B) was higher than in placenta previa without adherent placenta (Group A). We considered the occurrence of intrapartum
hypovolemic shock, Intensive care unit admission,
surgical complications and peripartum hysterectomy as parameters for morbidity. P value
for hypovolemic shock was insignificant (P = 0.580), significant for Intensive care unit admission (P = 0.008),
significant for surgical complications (P = 0.009)
and significant for peripartum hysterectomy