Table of Contents

2018 Month : November Volume : 7 Issue : 46 Page : 5743-5746

MATERNAL AND FOETAL OUTCOME IN ADHERENT PLACENTA AND ITS ASSOCIATION WITH PREVIOUS LOWER SEGMENT CAESAREAN SECTION AND HISTORY OF ABORTIONS.

Paga Anantha Lakshmi1, Patlolla Rajini2, Banoth Damayanthi3

Corresponding Author:
Dr. Patlolla Rajini,
Flat No. 306, Aditya Heights,
Opposite Botanical Garden,
Kondapur,
Telangana, India.
E-mail: dr.p.rajini@gmail.com

ABSTRACT

BACKGROUND

Placenta adherence is a significant cause of maternal morbidity and mortality. Normally, the placenta adheres to decidua basalis layer, allowing for a smooth separation of the placenta from the uterus after delivery. In patients with abnormal placentation, placenta is firmly bound to the defective decidua basalis layer or even to the myometrium giving rise to varying degrees of adherent placenta.

Aim- To study the demographic profile, maternal and foetal outcome of adherent placenta with history of previous lower segment caesarean section and previous history of abortions.

MATERIALS AND METHODS

A descriptive study of 23 pregnant women with adherent placenta was conducted at Modern Government Maternity Hospital, Petlaburj, Hyderabad for a duration of 2 years, i.e. from November 2014 to November 2016.

Study Design and Sample Size- This is a retrospective study and sample size is 23.

RESULTS

In our study, 95.7% of cases were associated with placenta previa and 91.3% were associated with previous caesarean section. Thus, placenta previa compounds the risk of adherent placenta in patients with history of caesarean section. Previous history of abortions where D & C was done is also a risk factor for adherent placenta. In our study, 7 cases (30.4) have undergone D & C previously. Out of them, 6 (26.1) had both previous LSCS and D & C and one patient (4.3) had history of D & C only. She had focal adherent placenta and conservative management was done.

CONCLUSION

All cases of adherent placenta, especially placenta percreta should be managed by multidisciplinary team involving a gynaecologist and urologist.1 Preoperative cystoscopy and placement of ureteric stents may aid in identifying the ureters.² Haemorrhage can be reduced by preoperative uterine artery balloon tamponade.

KEY WORDS

Adherent Placenta, Previous Caesarean Section, Dilatation and Curettage.

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