Publication:

Maternal outcomes in morbidly adherent placenta: a prospective cohort study

Background Morbidly Adherent Placenta (MAP), encompassing placenta accreta, increta, and percreta, is a life-threatening obstetric condition associated with high maternal morbidity and mortality. This study aimed to evaluate maternal outcomes in women diagnosed with MAP and to identify risk factors influencing morbidity and mortality.

Methods A prospective cohort study was conducted at a Government Medical College and Hospital, Akola, Maharashtra from Oct 2022 to Feb 2024, involving 50 women diagnosed with MAP. Data were collected regarding obstetric history, gestational age at delivery, estimated blood loss, need for hysterectomy, intensive care unit (ICU) stay, duration of hospitalization, and maternal mortality. Statistical analysis was performed to identify associations between previous Caesarean scars, emergency versus planned deliveries, and adverse outcomes.

Results The majority of patients (62%) had placenta accreta, followed by increta (26%) and percreta (12%). MAP incidence and severity increased with the number of prior caesarean scas. The mean estimated blood loss was 1950±450 mL, and 80% of patients required blood transfusion. Caesarean hysterectomy was performed in 38% of cases. ICU admission was required in 56%, and the average hospital stay was 8.4±2.7 days. Planned deliveries were associated with significantly lower blood loss and fewer complications compared to emergency deliveries.

Conclusions MAP remains a major cause of maternal morbidity, strongly associated with prior caesarean deliveries. Early antenatal diagnosis, and elective delivery in specialized centres significantly reduce blood loss, operative complications, and mortality.