Fauzia Anjum, Rabia Bashir, Arooba Rahim.
Maternal and Foetal Outcome in Cases of Placenta Previa, Accreta and Increta.
Ann King Edward Med Uni Jan ;22(4):296-300.
Objective: To evaluate the maternal and foetal out-come in cases of placenta previa, placenta accrete and placenta increta. Methods: Medical records of patients from 1 Feb 2014 to 28 Feb 2015 were checked and patients who underwent caesarean section with a diagnosis of pla-centa previa types III and IV (and placenta accreta, increta and percreta) were identified. Their medical record files were retrieved and data collected regarding patients age, parity, previous LSCS, D&C, blood loss, bladder injury, hysterectomy and use of B-lynch tech-nique were recorded. Neonatal statistics were also recorded regarding birth weight, gender, APGAR sco-re and need for admission in NICU. Results: In total 37 cases of major placenta previa were identified. These included 8 cases with placenta accrete including 2 cases of placenta increta. No mate-rnal death occurred amongst the studied cases. Only one case of IUFD was identified. The incidence of pla-centa previa (major) was 29.95/1000 births. Average parity of patients with placenta accreta (PA) was signi-ficantly higher than cases of placenta previa (PP) (2.75 vs. 1.55, p = 0.04). Similarly average number of LSCS in cases of PA was significantly higher than cases of PP (2.25 vs. 0.86, p = 0.02). PA cases were delivered at a significantly earlier gestational age as compared to cases with PP (34.5 weeks vs. 37 weeks, p = 0.01). Hysterectomy was done in 6 (75%) cases of PA but in none with PP. Bladder injury occurred in 2(25%) cases of PA but in none with PP. Blood loss was also signi-ficantly higher in PA cases than PP cases (3975 ml vs. 1196 ml, p = 0.006). Conclusion: At tertiary care hospitals, maternal and foetal outcomes for placenta previa and placenta acc-reta have improved owing to improved surgical techni-ques and better understanding of these conditions.
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