Incidence, Risk factors and Outcome of Morbidly Adherent Placenta at A Maternity Hospital

Abstract

Background: Morbidly adherent placenta is a dangerous pregnancy syndrome that is becoming more well acknowledged as a cause in rising incidence of maternal morbidity and mortality. In an effort to improve the mother's and the fetus's health. This study amid to determine risk factors, incidence and maternal outcome of morbidly adherent placenta at Zagazig maternity hospital to improve quality of health of mother and fetus. Methods: This recorded Interventional cohort study was conducted at attending antenatal care unit or emergency department of Zagazig Maternity Hospital. included pregnant Women with suspected or accidently diagnosed intraoperative with MAP. Total number of deliveries was 7761 While number of caesarian sections was 3586 & vaginal delivaries was 4175. All women were subjected to complete history-taking, clinical assessment and ultrasonography assessment. Results: Management strategies varied, with 50% undergoing caesarian hysterectomy, 50% conservative management. Pfannenstiel incision was used in 67.24% of cases, while midline incision was more common in hysterectomies (84.2%). Uterine artery ligation was performed in 93.10% of cases & internal iliac artery ligation in 12.07%, highlighting efforts to control bleeding and manage MAP effectively. Complications included urinary tract injuries in 31.03% of cases and ICU admissions for 10.34% of patients. Mortality recorded in one case(1.72%) . Fetal outcomes varied 56.90% of newborns required NICU admission, due to prematurity was 21%. Conclusion: Management strategies varied, with half of the cases undergoing hysterectomy, emphasizing the severity of the condition, while efforts were made to preserve fertility through conservative cesarean sections in a significant portion of patients