Evaluation of pregnancy outcomes & different management options used in Morbid Adherent placenta

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Mai Gobran ◽  
Abeer Hafeez ◽  
Rofiada ElShafie ◽  
Safaa Ibrahim ◽  
Mohamed Ramadan
Keyword(s):  
Pregnancy Outcomes ◽  
Management Options ◽  
Adherent Placenta

scholarly journals Assessment of different management options used in morbidly adherent placenta and pregnancy outcomes

2020 ◽  
Vol 3 (2) ◽  
pp. 01-05
Author(s):  
Waleed Tawfik
Keyword(s):  
Iliac Artery ◽  
Pregnancy Outcomes ◽  
Internal Iliac Artery ◽  
Placenta Previa ◽  
Management Options ◽  
Artery Ligation ◽  
Morbidly Adherent Placenta ◽  
Internal Iliac Artery Ligation ◽  
Adherent Placenta ◽  
Internal Iliac

The aim of this work is evaluation of different management options for patients with morbidly adherent placenta and its effect on pregnancy outcomes to find the best method of management to decrease morbidity and mortality. In this prospective study, there were 42 patients diagnosed as having morbidly adherent placenta previa and hospitalized between January 2019 to February 2020. Different management options performed to patients with morbidly adherent placenta previa were recorded, blood loss was estimated for each patient, operative procedures, maternal and fetal outcome was recorded. The results showed the following: Different methods were tried to preserve the uterus including bilateral uterine artery ligation in 13 (59%) cases, bilateral ovarian artery ligation in 3 (13.6%) cases, bilateral internal iliac artery ligation in 3 (13.6%) cases, intrauterine tamponade in 4 (18.1%) cases and hemostatic sutures in placental bed in 11(50%) cases, while B-lynch suture was not done, while procedures which were performed to control pelvic hemorrhage after hysterectomy included internal iliac artery ligation in 8 (27.5%) cases, pelvic packing in 5 (17.2%) cases and internal iliac balloon inflation to control hemorrhage in 1 (3.4%) case. The postoperative complications were DIC occurred in 2 patients (4.8%), ICU admission occurred in 5 cases (11.9%), two cases required reoperations, one patient (2.4%) had wound infection, Postpartum collapse occurred in 2 case (4.8%). Pulmonary embolism occurred in 1 case (2.4%), Median duration of hospital stay was 4 days (range: 2-25).

scholarly journals Interventions for improving pregnancy outcomes in antenatally diagnosed or suspected morbidly adherent placenta

2016 ◽  
Author(s):  
Rinku Sengupta ◽  
Alexis Gimovsky ◽  
Shuqin Wei ◽  
Anthony A Bamigboye ◽  
Vincenzo Berghella ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta

scholarly journals Conservative management options for morbidly adherent placenta

2017 ◽  
Vol 6 (3) ◽  
pp. 1057
Author(s):  
Meena N. Satia ◽  
Animesh Gandhi ◽  
Manali P. Shilotri
Keyword(s):  
Caesarean Section ◽  
Conservative Management ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Care Hospital ◽  
Management Options ◽  
Morbidly Adherent Placenta ◽  
Balloon Catheters ◽  
Adherent Placenta ◽  
Internal Iliac

Background: Morbidly adherent placenta is still a very significant cause of obstetric hemorrhage.Methods: A retrospective, descriptive study was undertaken over a period of one and a half year in a tertiary care hospital of all diagnosed cases of morbidly adherent placenta which were managed conservatively and the maternal and perinatal outcomes were noted. Preparation for conservative management of cases of adherent placenta in the antenatal period included informing interventional radiologists and placement of internal iliac balloon catheters just before classical caesarean section. Post-operative methotrexate was used in a few patients.Results: 11 cases of morbidly adherent placenta diagnosed on Doppler ultrasound scan, and confirmed by MRI were identified. All patients underwent classical caesarean section. 9 patients had internal iliac balloon placement. 5 patients received methotrexate. 3 patients required obstetric hysterectomy. 1 maternal and 2 perinatal mortalities were noted.Conclusions: Interventional radiology and methotrexate can be used to avoid peripartum hysterectomy and to optimize maternal and perinatal outcome.

scholarly journals Late Complication Due to Placenta Increta Left In Situ and Management Options

2011 ◽  
Vol 51 (184) ◽  
Author(s):  
S Zulfikir ◽  
M Al Bash ◽  
A Kakaria ◽  
V Gowri ◽  
A Saparamandu ◽  
...  
Keyword(s):  
Antenatal Diagnosis ◽  
Post Partum ◽  
Late Complication ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Management Options ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta

With the rising incidence of caesarean sections, the number of cases of placenta praevia and morbidly adherent placenta is increasing. Antenatal diagnosis and management in a tertiary care centre helps to reduce maternal and neonatal morbidity and mortality. We present a patient in whom the antenatal diagnosis of morbidly adherent placenta was missed due to late booking. In spite of the conservative approach at the time of caesarean section in the secondary care hospital, the patient presented with delayed complications and a total hysterectomy was performed. Keywords: adherent placenta, hysterectomy, methotrexate, post partum haemorrhage.

scholarly journals Sleep disordered breathing in pregnancy

Breathe ◽  
2015 ◽  
Vol 11 (4) ◽  
pp. 268-277 ◽  
Author(s):  
Bilgay Izci Balserak
Keyword(s):  
Risk Factors ◽  
Pregnancy Outcomes ◽  
Sleep Disordered Breathing ◽  
Adverse Pregnancy Outcomes ◽  
List Type ◽  
Management Options ◽  
Fetal Outcomes ◽  
Adverse Pregnancy ◽  
In Pregnancy ◽  
Disordered Breathing

Key pointsSleep disordered breathing (SDB) is common and the severity increases as pregnancy progresses.Frequent snoring, older age and high pre-pregnancy body mass index (>25 kg⋅m−2) could be reliable indicators for SDB in early pregnancy.SDB screening tools, including questionnaires, used in the nonpregnant population have poor predictive ability in pregnancy.Accumulating evidence suggests that SDB during pregnancy may be associated with increased risk of adverse pregnancy outcomes, including gestational diabetes and pre-eclampsia. However, the results should be interpreted cautiously because several studies failed to adjust for potential maternal confounders and have other study limitations.There are no pregnancy-specific practice guidelines for SDB treatment. Many clinicians and practices follow recommendations for the treatment in the general population. Women with pre-existing SDB might need to be reassessed, particularly after the sixth month of pregnancy, because symptoms can worsen with nasal congestion and weight gain.Educational aimsTo highlight the prevalence and severity of sleep disordered breathing (SDB) in the pregnant population.To inform readers about risk factors for SDB in pregnancy.To explore the impact of SDB on adverse maternal and fetal outcomes, and biological pathways for associated adverse maternal and fetal outcomes.To introduce current management options for SDB in pregnancy, including medical and behavioural approaches.Sleep disordered breathing (SDB) is very common during pregnancy, and is most likely explained by hormonal, physiological and physical changes. Maternal obesity, one of the major risk factors for SDB, together with physiological changes in pregnancy may predispose women to develop SDB. SDB has been associated with poor maternal and fetal outcomes. Thus, early identification, diagnosis and treatment of SDB are important in pregnancy. This article reviews the pregnancy-related changes affecting the severity of SDB, the epidemiology and the risk factors of SDB in pregnancy, the association of SDB with adverse pregnancy outcomes, and screening and management options specific for this population.

scholarly journals Morbidly Adherent Placenta: Management options

2021 ◽  
Vol 31 (01) ◽  
pp. 3-7
Author(s):  
Abida Sajid ◽  
Aqsam Sajid Aqsam Sajid ◽  
Arham Sajid Arham Sajid ◽  
Maham Abid Maham Abid
Keyword(s):  
Maternal Morbidity ◽  
Tertiary Care ◽  
Case Series ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Management Options ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
Vaginal Deliveries ◽  
Maternal Morbidity And Mortality

Background Placenta previa with placenta accreta spectrum is one of the most feared complications responsible for increased maternal morbidity and mortality. This study aims to reduce maternal morbidity and mortality by detecting risk factors, performing relevant investigations, and deciding appropriate management options. Methods: The study design is a descriptive case series, carried out on 72 patients of MAP of a tertiary care hospital, in a 6-years duration from January 2014 to December 2019. Patients of OPD and the emergency department were diagnosed for MAP by using grayscale ultrasounds, color Doppler USG's (in most cases), and MRI's (in only a few cases). Different management options were studied and maternal morbidities were observed.  In the majority of cases, patients had operative deliveries with planned/ emergency hysterectomies, except for some having conservative surgery. Results: In the period of 6 years, the total number of deliveries was 35940. Out of these, 22140 were spontaneous vaginal deliveries and 13800 were C-sections.  The incidence of MAP was 1 per 499 normal deliveries and 1 per 192 in C-sections. The criteria for MAP was fulfilled by 72 patients. MAP diagnosed in the antenatal period was 43% while 57% were diagnosed in an emergency. The majority of patients had a history of C-sections and many underwent emergency obstetric hysterectomies. Blood transfusions were given to all patients in our study. Only 4(5.5%) patients died in our study. Conclusion:      Antenatal diagnosis of morbidly adherent placenta, followed by a well-planned surgical management, avoidance of placental separation and early caesarean hysterectomy ultimately result in a better maternal outcome. Keywords: Morbidly Adherent Placenta, Maternal Morbidity, Massive Obstetric Hemorrhage, Obstetric Hysterectomy.  

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