Frequency of Morbidly Adherent Placenta in Previous Scarred Uterus and its Complications

Background: Morbidly adherent placenta is a serious complication in obstetrics, where there is abnormal placental implantation in the uterus with failure to separate after delivery. This complication is more common in women who have a scarred uterus, especially after a cesarean delivery. This complication may lead to serious consequences for both mother and child. Objective: To determine the frequency of morbidly adherent placenta in previous scarred uterus and to evaluate its associated maternal and neonatal complications. Study Design: Descriptive cross sectional study. Duration and Place of Study: This study was carried out from 05 September 2023 to 05 March 2024 in the Department of Obstetrics and Gynecology, Lady Reading Hospital Peshawar. Methodology: A total of 139 pregnant women aged 18–40 years with previous uterine scar and gestational age ≥28 weeks were included. Detection of morbidly adherent placenta was done using Doppler ultrasonography and magnetic resonance imaging. Data analysis was done using Statistical Package for Social Sciences version 25. Results: Morbidly adherent placenta was observed in 44 patients (31.70%). Among them placenta increta was seen in 43.18%, placenta percreta in 29.55% and placenta accreta in 27.27%. Hysterectomy occurred in 81.80%, low birth weight in 59.10%, preterm delivery in 54.50%, neonatal intensive care unit admission in 56.80% and maternal mortality in 4.50% of affected cases. Conclusion: Morbidly adherent placenta is relatively common in women with previous scarred uterus and it is associated with serious maternal and neonatal complications.