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Placenta Accreta and its Management and Outcomes in Tertiary Centre: Low Resource Settings

K.S. Chitra, Professor, Department of Obstetrics and Gynaecology, Government Rajaji Hospital (GRH), Madurai Medical College, Madurai, Tamil Nadu 625020, India. , C. Shanthi1 , K.S. Chitra2

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Indian Journal of Obstetrics and Gynecology 7(1):p 27-30, Jan-Mar 2019. | DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.7119.5

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Abstract

 Background: This is an era of increasing trend in placenta accreta in modern obstetrics. The aim of this study is to identify the risk factors of such cases, early antenatal diagnosis, peripartum management protocol, and to evaluate maternal and neonatal outcome in tertiary care centre. Method: It is a prospective study conducted for a span of one year from 2017-2018. Result: A total of 15 cases of placenta accreta were identified and studied in Madurai medical college from March 2017 to April 2018. It was found that 40% cases were above 30 years of age, 93% have previous ceaserean section history and 26% have previous dilatation and curettage history. 73% cases underwent hysterectomy, and almost all cases required ICU admission and blood transfusion. One case of bladder injury was reported (6%). Neonatal outcomes include preterm birth (53%), 60% cases required NICU admission. one perinatal death was observed. Conclusion: placenta accreta cases are highly associated with increasing caesarean section rate, high maternal age and repeated curettage. It causes adverse maternal and neonatal morbidity and mortality. Hence prompt antenatal diagnosis with ultrasound and planned management in multidisciplinary setup helps in reducing morbidity and mortality.

Keywords: Placenta accreta; Caesarean section; Hysterectomy; ICU, NICU.

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DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.7119.5

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