TITLE:
Outcome of Patients with Placenta Accreta at El Shatby Maternity University Hospital
AUTHORS:
Eman Ali AbdElfatah, Elsayed Elbadwy Mohamed Awad, Tamer Mamdouh Abd-Eldaym, Zynab Hassan Ali
KEYWORDS:
Pregnancy, Cesarean Deliveries, Placenta Accreta, Postpartum Haemorrhage, Blood Transfusion, Hysterectomy
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.7 No.7,
July
13,
2017
ABSTRACT: Objective: The aim of this study was to determine the incidence, risk factors,
and outcomes of management of patients with placenta accreta. Background
Placenta accreta occurs when the placental implantation is abnormal. The
marked increase in incidence has been attributed to the increasing prevalence
of cesarean delivery in recent years. The most common theory is defective decidualization.
The most important risk factor for placenta accreta is placenta
previa after a prior cesarean delivery. The first clinical manifestation of placenta
accreta is usually profuse, life-threatening hemorrhage. The recommended
management of suspected placenta accreta is planned preterm cesarean
hysterectomy with the placenta left in situ. Patients and methods: It’s a
study of all cases of placenta accreta at El-Shatby Maternity University Hospital
starting from 1/4/2016 till 1/10/2016. Selection of the cases will only be
dependent upon their pregnancy gestational age above 28 weeks of gestation.
Results: The incidence of placenta accreta was 1/75 cesarean deliveries. The
ultrasonography and doppler had a false negative rate of 54.6% and a sensitivity
of 45.2% in diagnosis of placenta accreta. The rate of blood transfusion was
79.6%. Uterine preserving procedures performed in 66%. Cesarean hysterectomy
performed in 34%. Intensive care unit admission occurred in 27.3%.
The mean gestational age at delivery was 33.8 ± 4.6 weeks’ gestation. 31.8%
admitted to the neonatal intensive care unit. Conclusion: The incidence of
placenta accreta increased due to the increasing rate of cesarean deliveries,
prenatal diagnosis of placenta accreta is paramount, as most women are
asymptomatic. Prenatal diagnosis allows time for a multidisciplinary team to
make delivery plans, which will help decrease surgical complications.