scholarly journals Maternal Morbidity in Women with Placenta Previa Managed with Prediction of Morbidly Adherent Placenta by Ultrasonography

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Midori Fujisaki ◽  
Seishi Furukawa ◽  
Yohei Maki ◽  
Masanao Oohashi ◽  
Koutarou Doi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Maternal Morbidity ◽  
Placenta Previa ◽  
Cumulative Number ◽  
Clear Zone ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
Placental Lacunae

Objective. To determine maternal morbidity in women with placenta previa managed with prediction of morbidly adherent placenta (MAP) by ultrasonography. Methods. A retrospective cohort study was undertaken comprising forty-one women who had placenta previa with or without risk factors for MAP. Women who had all three findings (bladder line interruption, placental lacunae, and absence of the retroplacental clear zone) were regarded as high suspicion for MAP and underwent cesarean section followed by hysterectomy. We attempted placental removal for women having two findings or less. Results. Among 28 women with risk, nine with high suspicion underwent hysterectomy and were diagnosed with MAP. Three of 19 women with two findings or less eventually underwent hysterectomy and were diagnosed with MAP. The sensitivity and positive predictive value for the detection of MAP were 64% and 100%. The pathological severity of MAP was significantly correlated with the cumulative number of findings. There were no cases of MAP among 13 women without risk. There was no difference of blood loss between women with high suspicion and those without risk (2186±1438 ml versus 1656±848 ml, resp.; p=0.34). Conclusion. Management with prediction of MAP by ultrasonography is useful for obtaining permissible morbidity.

scholarly journals A retrospective analysis on placenta previa in a tertiary care center of Jharkhand

2021 ◽  
Vol 10 (9) ◽  
pp. 3389
Author(s):  
Tanu Sharma
Keyword(s):  
Risk Factors ◽  
Perinatal Outcome ◽  
Maternal Morbidity ◽  
Placenta Previa ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Adherent Placenta ◽  
History Of ◽  
Nicu Admission

Background: When the placenta is implanted partially or completely in the lower uterine segment, it is called placenta previa. Previa is a Latin word means going before. About one-third of APH belongs to placenta previa and now a day’s incidence is increasing in primigravida patients. The objective of this study was to analyze the incidence, risk factors, maternal morbidity, mortality and perinatal outcome in women with placenta previa in a tertiary care center of Jharkhand.Methods: Total 193 cases of placenta previa were studied between September 2018 to August 2019 in the department of obstetrics and gynecology, RIMS, Ranchi with respect to their age, parity, gestational age, clinical presentation, previous history of curettage/hysterotomy/caesarean, ICU admission, need for NICU admission, maternal morbidity and mortality and perinatal outcome.Results: In this study, 1.94% of the deliveries were complicated with placenta previa. 31.6% were above 30 years, 87% were multigravida, 122, i.e.; 62.7% were having history of curettage or previous caesarean or hysterotomy. 49.7% had prior caesarean deliveries, 21.5% had prior abortion with history of D and C. 49.2% had true placenta previa. 68.4% had preterm delivery. 11.9% patients presented in shock and maximum i.e.; 184 (95.3%) out of 193 presented with painless bleeding per vaginum and 9 cases with no complaints. Malpresentation seen in 16.6% cases and 8.3% had adherent placenta previa. There were 45.6% ICU admission and 54.9% NICU admission, 2.5% maternal mortality and 32.6% perinatal mortality.Conclusions: Advanced maternal age, multiparty, scarred uterus as in prior CS or D and C are independent risk factors for placenta previa. Also, it remains a risk factor for adverse maternal and perinatal outcome. The detection of placenta previa and associated adherent placenta should encourage a careful evaluation, timely diagnosis and delivery to reduce associated maternal and perinatal complications.

scholarly journals Use of a Fibrin Sealant Patch at Cesarean for Conservative Management of Morbidly Adherent Placenta

2018 ◽  
Vol 08 (04) ◽  
pp. e325-e327 ◽  
Author(s):  
James Greenberg ◽  
Julian Robinson ◽  
Jean Carabuena ◽  
Michaela Farber ◽  
Daniela Carusi
Keyword(s):  
Cesarean Delivery ◽  
Fibrin Sealant ◽  
Maternal Morbidity ◽  
Placenta Previa ◽  
Morbidity And Mortality ◽  
Artery Embolization ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
Maternal Morbidity And Mortality ◽  
Repeat Cesarean Delivery

Background Morbidly adherent placenta represents a surgical challenge and source of maternal morbidity and mortality. We report the use of a fibrin sealant patch to address hemorrhage associated with a morbidly adherent placenta during cesarean delivery. Case A patient underwent repeat cesarean delivery with complete anterior placenta previa and anticipated morbidly adherent placenta. Bleeding persisted following delivery and removal of the placenta, despite uterine artery embolization. A fibrin sealant patch was applied as an adjuvant intervention to the placental bed and hemostasis was achieved without resorting to a hysterectomy. Conclusion Postpartum hemorrhage is an ongoing leading source of maternal morbidity and mortality. A case is presented in which a fibrin sealant patch provided control of focal placental bed bleeding, allowing removal of a focal morbidly adherent placenta and avoidance of hysterectomy.

scholarly journals Fetomaternal outcome in morbidly adherent placenta in a tertiary referral hospital

2018 ◽  
Vol 7 (11) ◽  
pp. 4540
Author(s):  
Amudha Paneerselvam ◽  
Asha Sundaram
Keyword(s):  
Risk Factors ◽  
Placenta Previa ◽  
Admission Rate ◽  
Preterm Neonates ◽  
Blood Transfusions ◽  
Tertiary Referral Hospital ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
The Mean ◽  
Caesarean Hysterectomy

Background: Morbidly adherent placenta is often associated with major pregnancy complications requiring massive blood transfusions, peripartum hysterectomy, etc. The prior number of caesarean sections and placenta previa are the critical risk factors. The aim of this study is to evaluate the fetomaternal outcome in women with morbidly adherent placenta and to quantify the risk factors predisposing to it.Methods: This is a retrospective cohort study. The study population comprises women, who had C-section for placenta accreta, increta and percreta at Government Raja Mirasudhar Hospital, Thanjavur from May 2016 to September 2017.Results: Eighteen women out of 21,083 who delivered during the study period had morbidly adherent placenta with an incidence of 0.085%. The mean gestational age at the time of C-section was 32.4 weeks. Twelve (66.66%) out of eighteen women had prior one C-section, two (11.11%) women had prior 2 C-section and two (11.11%) women had prior 3 C-section.10 cases were diagnosed antenatally by radiological imaging. Seventeen out of eighteen women underwent caesarean hysterectomy (94.44%). Average blood loss was 1.8 litres. The mean intraoperative blood transfusions were 3 units of PRBC, 3 units of FFP and 1.4 units of platelet. There was no maternal mortality. The average total hospital stay was 20.46 days. 11 neonates were preterm (61%) and 5 neonates were term (27.74%). FGR was seen in 2 preterm neonates (12.5%). The NICU admission rate was 81% (n=13). The perinatal mortality rate was 31.25% (n=5).Conclusions: As most of the women ended up in caesarean hysterectomy, early diagnosis will enable appropriate planning for blood components, anaesthetic and surgical resources, thereby reducing adverse fetomaternal outcomes. This will also allow adequate preoperative counselling of the women involved.

scholarly journals Placenta praevia: percreta and accreta, our experience

2020 ◽  
Vol 9 (3) ◽  
pp. 928
Author(s):  
Preeti F. Lewis ◽  
Shreya Chinchoriya
Keyword(s):  
Risk Factors ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
History Of ◽  
Previous Cesarean

Background: morbidly adherent placenta has an increasing incidence over decades. The purpose of this study is to identify risk factors and etiology of placenta previa- accreta and percreta.Methods: A cross sectional observational study of patients with morbidly adherent placenta previa including placenta accreta and placenta percreta were studied over a period of three years from June 2017 to June 2019 in a tertiary care centre, Mumbai.Results: Cases showed a higher incidence in patients with previous cesarean delivery (CS), grandmultiparity, abortions without the history of check curettage and anterior/central placentae.Conclusions: History of uterine surgeries and previous cesarean are some important risk factors for accreta in placenta previa patients.

scholarly journals Effects of Placenta Location in Pregnancy Outcomes of Placenta Accreta Spectrum (PAS); A Retrospective Cohort Study

2021 ◽  
Author(s):  
Shokoh Abotorabi ◽  
Solmaz Chamanara ◽  
Sonia Oveisi ◽  
Maryam Rafiei ◽  
Leila Amini
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Chi Square ◽  
Gestational Age At Delivery ◽  
History Of ◽  
Placenta Accreta Spectrum

Objective: Placenta Accreta Spectrum (PAS) affects approximately one in a thousand deliveries. Very few studies evaluated PAS risk factors based on their location. In this study, we have investigated the effects of placenta location on placental adhesion-related complications, its risk factors, and outcomes. Materials and methods: We performed a retrospective cohort study of pathology-confirmed cases of PAS from patients with peripartum hysterectomy, at a large educational hospital in Qazvin, Iran, from 2009 to 2019. Placenta location was found by ultrasound reports and intraoperative evaluation. We measured demographic features, basic characteristics, maternal and neonatal outcomes based on placental location including anterior, posterior, and lateral in Placenta Accreta Spectrum. Chi-square, t-test, and one-way ANOVA were used to examine the relation of complications, risk factors, and outcomes in PAS. Results: A review of 70 cases showed the distribution of placenta location as follows: 57% anterior, 27% posterior, and 16% lateral. The mean gestational age at delivery was 35 (33-39) weeks. In 78.6% (n=55) of the patients, an association with placenta previa and in 94/2% (n=66) of cases a history of cesarean section was found, however, it was not significantly correlated with placenta location (p=0.082). We found that surgery duration was significantly longer in patients with lateral PAS (155±38, vs 129.35±33.8 and 133.15±31.5 for anterior and posterior placenta respectively, p=0.09). Patients with lateral PAS also bled more than the remaining two groups (2836 ml for lateral PAS vs 2002 and 1847 for anterior and posterior placenta respectively, p=0.022). Moreover, women with a history of uterine surgery were more likely to have posterior PAS compared to those with anterior and lateral PAS (p=0.035). Conclusion: Differences in complications, risk factors, and outcomes of PAS based on placenta location may lead to improved diagnosis and decreased morbidity in women.

An Ultrasound Scoring Model for the Prediction of Intrapartum Morbidly Adherent Placenta and Maternal Morbidity: A Cross-Sectional Study

2019 ◽  
Author(s):  
Dahlia O. El-Haieg ◽  
Nadia M. Madkour ◽  
Mohammad Abd Alkhalik Basha ◽  
Reda A. Ahmad ◽  
Somayya M. Sadek ◽  
...  
Keyword(s):  
Maternal Morbidity ◽  
Color Doppler ◽  
Bladder Wall ◽  
Cross Sectional Study ◽  
Perfect Agreement ◽  
Cross Sectional ◽  
Morbidly Adherent Placenta ◽  
Scoring Model ◽  
Adherent Placenta ◽  
Placental Lacunae

Abstract Objective To design an ultrasound scoring model for the prediction of the intrapartum morbidly adherent placenta (MAP) and maternal morbidity. Patients and Methods 114 females with singleton pregnancies ≥ 28 weeks of gestation referred for suspicion of MAP were included. All patients underwent examination by two-dimensional ultrasound with the color Doppler setting. Five signs were evaluated: the retroplacental echolucent space, placental lacunae, the hyperechoic uterine-bladder interface, retroplacental myometrium thickness, and subplacental, uterine serosa-bladder wall, intraplacental and bladder wall vascularity. We designed a score ranging from 0 – 8.5 points, including the five signs according to their odds ratios and evaluated its prediction for MAP and maternal morbidity. Results Using multivariate logistic regression, all ultrasound signs were significant dependent predictors for both MAP and maternal morbidity (myometrium thickness < 1 mm followed by lacunae ≥ 4 and lost retroplacental echolucent space). The only independent predictors for MAP were myometrium thickness < 1 mm and lacunae ≥ 4, while myometrium thickness < 1 mm and lost retroplacental echolucent space were predictive for maternal morbidity. The score showed a perfect agreement with MAP and a good one for maternal morbidity. Conclusion Application of the score we designed can improve the ultrasound diagnosis of MAP and the maternal outcome.

scholarly journals Evaluation of the risk factors for antepartum hemorrhage in cases of placenta previa: a retrospective cohort study

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110547
Author(s):  
Momoko Kuribayashi ◽  
Hiroyuki Tsuda ◽  
Yumiko Ito ◽  
Atsuko Tezuka ◽  
Tomoko Ando ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Vaginal Delivery ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Placenta Previa ◽  
Significant Risk ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
History Of

Objective The aim of this study was to examine the risk factors for antepartum hemorrhage (APH) in women with placenta previa. Methods In this retrospective cohort study, we analyzed the medical records of 233 women with singleton pregnancies presenting with placenta previa whose deliveries were performed at our hospital between January 2009 and July 2018. Results Of the 233 women included in this study, 130 (55.8%) had APH. In the APH group, the gestational age and neonatal birth weight were significantly lower compared with the no hemorrhage group. Maternal age <30 years and multiparity were identified as significant risk factors for APH in both the univariate and multivariate analyses. Focusing on the previous route of delivery in multiparous women, the risk of APH was significantly higher in multiparous women who had experienced at least one vaginal delivery compared with nulliparous women (adjusted odds ratio (OR): 3.42 [95% confidence interval: 1.83–6.38]). Conclusion We showed that women with placenta previa who were under 30 years old and who had a history of vaginal delivery may be at significant risk of experiencing APH.

Morbidly adherent placenta previa in current practice: prediction and maternal morbidity in a series of 23 women who underwent hysterectomy

2014 ◽  
Vol 27 (17) ◽  
pp. 1734-1737 ◽  
Author(s):  
Haifa’a Alchalabi ◽  
Isam Lataifeh ◽  
Basil Obeidat ◽  
Faheem Zayed ◽  
Yousef S. Khader ◽  
...  
Keyword(s):  
Maternal Morbidity ◽  
Current Practice ◽  
Placenta Previa ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta

scholarly journals MATERNAL MORBIDITY

2016 ◽  
Vol 23 (10) ◽  
pp. 1183-1186
Author(s):  
Sumera Shaikh ◽  
Kiran Wassan
Keyword(s):  
Blood Transfusion ◽  
Postpartum Hemorrhage ◽  
Maternal Morbidity ◽  
Placenta Previa ◽  
Obstetrics And Gynecology ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
Scarred Uterus ◽  
Tools And Techniques ◽  
Pro Forma

Objective … To determine the frequency of maternal morbidity in patients withmajor degree of placenta previa in a previously scarred uterus. Study Design: Descriptivestudy. Setting: Department of Obstetrics and Gynecology Liquat University of medical andHealth Sciences, Jamshoro. Period: April 1st 2012 to Sep 30th 2012. Methods: The data wascollected on pre-designed pro-forma by the researcher. Tools and techniques were analyzedthrough SPSS version 15. Results The Following results were drawn by the study: Themean age of enrolled participants was 32.5±4.7 years, mean parity was 3.8±1.4 and meangestational age was 34.7±2.9 weeks. The frequency of morbidly adherent placenta was 23.7%,postpartum hemorrhage 21.9%, blood transfusion >4 47.2% and cesarean hystrectomy was12.3% cases. Conclusions: It is concluded from this study that morbidly adherent placenta was23.7%, postpartum hemorrhage 21.9%, blood transfusion >4 47.2% and cesarean hystrectomywas 12.3% cases.

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