Maternal and neonatal outcomes of morbidly adherent placenta in Ain Shams University Maternity Hospital from 2012 to 2017

Abstract

Morbidly adherent placenta (MAP) is now a significant obstetric challenge results in significant maternal morbidity and mortality (it is responsible for 7-10% of maternal mortality). The incidence of MAP have increased over the past few decades, this is mainly because of the increasing caesarean delivery rate. Risk factors for MAP include placenta previa, cesarean delivery, high maternal age and high parity. Optimal management of MAP involves early recognition of high risk women based on clinical risk factors, accurate preoperative diagnosis, detailed maternal counselling and meticulous planning at the time of delivery. Although management of MAP depends on extent of the problem, literature favours use of conservative treatment as it can help to avoid caesarean Hysterectomy and involves a decreased rate of severe maternal morbidity in well-resourced centres. Inappropriate management can comprise the maternal outcome resulting in many complications such as sepsis, septic shock, peritonitis, uterine necrosis, fistula, injury to adjacent organs, acute pulmonary edema, acute renal failure, deep vein thrombophlebitis or pulmonary embolism, or death due to postpartum hemorrhage or myelosuppression and nephrotoxicity.