Maternal and neonatal outcomes of placenta accreta: a descriptive case series study

Abstract

Objective The objective of this study was to evaluate maternal and neonatal outcomes of placenta accreta. Background Placenta accreta is the leading cause of maternal and neonatal morbidity and mortality. Patients and methods This descriptive case series study included 40 pregnant women with placenta accreta and was carried out at Department of Obstetrics and Gynecology of Menoufia University Hospitals for 10 months. The study cohort included all admitted pregnant women with the diagnosis of placenta previa accreta whether presenting with or without vaginal bleeding after 28 weeks of gestation confirmed by ultrasound scan. Data were collected and confirmed by positive ultrasonographic criteria of placenta accreta. The study outcomes included maternal mortality, urinary tract injuries, cesarean hysterectomy admission to ICU, preoperative and postoperative hospital stay, perinatal mortality, neonatal birth weight, Apgar score at 1 and 5 min, admission to neonatal ICU, or any other complications. Results Our study included 40 patients, and there was a highly significant statistical difference between patients who underwent hysterectomy (n = 21) and who did not (n = 19) regarding type of cesarean delivery (elective or emergency) (P = 0.005). There was a significant statistical difference in neonatal mortality in cases that were admitted to ICU (P = 0.040). Conclusion Morbidly adherent placenta is becoming an increasingly common complication of pregnancy with increasing rates of cesarean births. Prenatal diagnosis and management is the most important factor in optimizing the treatment and outcome of women with adherent placenta.