Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Placenta previa and Morbidly Adherent Placenta (MAP) are serious obstetric conditions associated with high maternal and neonatal morbidity. Placenta previa, where the placenta overlies or nears the cervical os, increases risks of hemorrhage, preterm birth and surgical delivery. The MAP-involving accreta, increta and percreta-entails excessive placental invasion, often necessitating hysterectomy. Rising cesarean rates have driven up the incidence of both conditions, highlighting the need to evaluate outcomes and optimize management. This 2024 prospective observational study at a tertiary care center enrolled 200 women $18 years diagnosed with placenta previa (n = 140) or MAP (n = 60) via ultrasound or MRI. Exclusions included multiple gestations, fetal anomalies and major maternal comorbidities. Data on demographics, surgical variables and neonatal outcomes were collected. Placenta previa was classified per FIGO guidelines; MAP was confirmed intraoperatively and by imaging. Primary outcomes included blood loss, transfusion, hysterectomy, ICU admission, gestational age, birth weight, NICU admission and perinatal mortality. Statistical analyses (chi-square, t-test, logistic regression) were performed in SPSS v26.0 with significance at p<0.05. MAP cases had higher mean blood loss (2200 vs. 1100 mL, p<0.001), transfusion rates (83% vs. 30%, p<0.001), hysterectomy rates (46% vs. 4%, p<0.001) and ICU admissions (33% vs. 9%, p<0.001) compared to placenta previa. Neonates from MAP pregnancies were more often preterm (<37 weeks: 83% vs. 40%, p<0.001), had lower birth weights (2.4 vs. 2.9 kg, p<0.001), higher NICU admissions (77% vs. 24%, p<0.001) and greater perinatal mortality (17% vs. 4%, p=0.002). Previous cesarean delivery was significantly associated with MAP (93% vs. 56%, p<0.001). MAP is linked to markedly worse maternal and neonatal outcomes than placenta previa alone, driven largely by prior cesarean deliveries. Early identification, multidisciplinary planning and scheduled delivery protocols are essential to mitigate risks in these high-risk pregnancies.
How to cite this article:
Ann Baby and P.M. Seetha. Fetomaternal Outcome in Placenta Previa and Morbidity Adherent Placenta in A Tertiary Care Centre.
DOI: https://doi.org/10.36478/makrjms.2024.12.798.802
URL: https://www.makhillpublications.co/view-article/1815-9346/makrjms.2024.12.798.802