Morbidly adherent placenta and it’s maternal and fetal outcome

Background: Morbidly adherent placenta, a grave complication of pregnancy is becoming an emerging cause of increased maternal morbidity and mortality. Objectives of present study are to evaluate the etiopathogenesis of MAP, its clinical mode of presentation and maternal and fetal outcome with the aim to reduce maternal morbidity and mortality. Methods: It was a retrospective and prospective study at Umaid Hospital, attached to Dr. S.N. Medical College, Jodhpur in which data of patients with clinical diagnosis of MAP were reviewed from October 2014 to January 2016. Results: In this study of 10 cases of morbidly adherent placenta of Umaid hospital from October-2014 to January 2016 were studied, it was found that the mean age of presentation was 30.2 year. 60% cases were unbooked and 40% cases were booked with regular ANC visit. 60% cases presented with bleeding per vagina as a chief complaint and 30% cases were admitted for elective LSCS. 60% cases were already diagnosed case of placenta praevia. 90% cases had a history of previous LSCS. 80% cases were given BT intraoperatively and postoperatively. 60% cases underwent caesarean hysterectomy, 80% cases were shifted to ICU, and there was one maternal death. Conclusions: The incidence of MAP is increasing due to higher cesarean section (C/S) rate. Antenatal diagnosis via USG and color-doppler imaging, preoperative counseling, planning and multidisciplinary approach is necessary to reduce morbidity and mortality associated with MAP.