Abstract
Background:Morbidly adherent placenta (MAP) is one of the obstetric emergencies, if not diagnosed and managed properly.Objective: The objective of the study was to compare maternal outcomes in patients with morbidly adherent placenta managed in a multidisciplinary team setting compared to standard care.Study type,settings & duration:A comparative cross-sectional study was conducted in obstetrics and gynecology Department, Liaquat University of Medical and Health Sciences for a period of two years from June 2018 to May 2020.Methodology:A total of 40 patients were enrolled, using convenient sampling technique. All patientseither booked, un-booked, referral or who came as emergency cases with morbidly adherent placenta (including Accreta, Increta, Percreta) confirmed on TVS, MRIor clinically diagnosedduring surgery wereincluded in study. A questionnaire was used to retrieve the required data for statistical analysis. Chi-square test was applied and p-value ≤ 0.05 considered as level of significance.Results:Twenty study participants (50%) were booked cases and ante-natally diagnosed cases of MAP and 60% of them were admitted in the hospital, most of them were in the age group 20-30 years and all (100%) had history of previous caesarean section.Almost 88% were at or more than 35 weeks of pregnancy. Around 48% Percreta, 27% Accreta and 25% Increta types of MAP were found during surgical procedure. Out of 40 enrolled patients 26 (65%) were managed by multidisciplinary care while 14 (35%) by Standard care. There were less complications (p=0.057) and statistically significant better maternal (p=0.040) and fetal outcomes (p=0.050) were found in multidisciplinary team management as compared to the standard care.Conclusion: The MAP was common in multiparous women with history of previous cesarean sections. The most common MAP types were Placenta Accreta and Percreta. Antenatal diagnosis of MAP allows multidisciplinary team to plan for expected case management in an attempt to minimize potential maternal or neonatal morbidity and mortality,
Fahmida Perveen, Samia Aijaz, Sakeena Ahmed Memon, Farah Naz Memon, Rizwana Enayat. (2021) Maternal Outcomes in the Management of Morbidly Adherent Placenta: Multidisciplinary Team vs. Standard Care at a Tertiary Care Hospital, Pakistan Journal of Medical Research, Volume-60, Issue-1.
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