Frequency of Morbidly Adherent Placenta in Previous Scar

Abstract

OBJECTIVE: To assess the frequency of different types of morbidly adherent placenta in womanpresenting history of previous scar.METHODOLOGY: This descriptive cross-sectional study was conducted from December 2016 to June2017 at Department of Obstetrics & Gynaecology, Indus Medical College Hospital Tando MuhammadKhan & Liaquat University of Medical & Health Sciences Jamshoro. A total of 205 patients with agewomen between 15 to 49 years, with having pregnancy of 04 to 36 weeks, alive singleton fetus, history ofprevious surgery like Caesarean Section, myomectomy, hysterotomy and associated placenta praeviawere included. Patients with history of pelvic inflammatory disease (PID), dilatation and curettage (D&C)and intrauterine contraceptive device (IUCD) insertion, placenta abruption and primigravida wereexcluded. Mean+SD, frequencies & percentages were calculated. Chi-square test was used as a test ofsignificance with a P value <0.05.RESULTS: Around 45.4% (n=93) women had scar due to previous caesarean section. Morbidly adherentplacenta was found positive among 9.76% (n=20) women. Frequency of Placenta accreta vera was 1.5%(n = 3), Placenta increta was 6.76% (n = 14) and Placenta percreta was 1.5% (n=3). Stratified analysisfound that risk of Morbidly adherent placenta (MAP) elevated with the increasing age, second trimester,high parity, having previous caesarean section & shorter the duration of scar.CONCLUSION: Morbidly adherent placenta is not a very uncommon condition. Its frequency is ten timesmore among women who had previous history of scar. Hence, the previous scared uterus and shorterduration increased further risk for all three types of morbidly adherent placenta.