STUDY OF MATERNALAND PERINATAL OUTCOME IN MORBIDLY ADHERENT PLACENTAAT A TERTIARY CARE CENTER

Background: Placenta accreta spectrum is a pathologic condition of placentation in which the villous tissue adheres or invades the uterine wall. Present study was aimed to study cases of abnormal placentation in the form of placenta accreta spectrum and the maternal and perinatal outcomes associated with it in our hospital. Material and Methods: Present study was single-center, prospective, observational study, pregnant female, gestational age>32weeks, with morbidly adherent placenta diagnosed antenatally by USG/ DOPPLER/ MRI or per operatively (on table). Maternal & Perinatal, outcomes & parameters were studied. Results: Among 58 patients' majority were (43.1%) of the age group of 30 to 34 years, were third gravida (41.4%), 33 (56.9%) delivered before 37 weeks of gestation. 56 (96.6%) patients had at least one LSCS in past pregnancies, 22 (37.9%) had prior curettage, 20 (34.5%) had prior LSCS and curettage, 49 (84.5%) had associated placenta previa. 31 out of 58 patients (53.3%) were diagnosed with morbidly adherent placenta antenatally on ultrasound doppler or MRI and 27 patients (46.6%) were intraoperatively (on table) diagnosed. 33 (56.9%) were diagnosed with placenta percreta, 16 (27.6%) had placenta increta and 9 (15.2%) were diagnosed with placenta accreta. 48 (82.8%) patients had hysterectomy as the rst line of treatment. 47 patients (81%) were shifted to ICU, 23 patients (39.7%) had bladder injuries due to placenta percreta invading the bladder, 30 patients (51.7%) had haemorrhagic shock, sepsis was seen in 3 (5.2%) patients, 2 patients (3.4%) landed in DIC and there were 3 (5.2%) mortalities. 33 (56.8%) neonates had APGAR score at 5 mins of < 7, 58.6% were born preterm, 55.1% required NICU admissions, and 13.7% died in neonatal period. Conclusion: Morbidly adherent placenta is one of the most devastating complications in pregnancy, associated with signicant and increased maternal and perinatal mortality and morbidity.