Abstract

Background: morbidly adherent placenta is defined as an abnormal adherence of all or part of the placenta to the underlying uterine wall. Aim of the work: this study aimed to evaluate the management of morbidly adherent placenta in Ain Shams Maternity Hospital during the 5-year period from January 2012 to December 2016.Study Design: this is a retrospective study. Study Setting: Ain Shams University Maternity Hospital. Patients and Methods: records of hospital admissions during the planned time frame with the diagnosis of antepartum hemorrhage or placenta accreta/increta/percreta were reviewed. Results: Ain Shams University Maternity Hospital (ASUMH) is a major tertiary referral hospital in Egypt. In evaluation of the management and short term maternal and perinatal outcomes of morbidly adherent placenta offered to women at ASUMH, the hospital archives were examined for hospital records fulfilling the criteria of this study population during the 5-year period from January 2012 to December 2016. During the 5-year period of the current study, there were 58,529 deliveries; 29,282 cases; they were delivered by CS (50.03%). MAP was diagnosed in 429 cases 0.7 % of total deliveries with an incidence of 1 in 136, 1.5% of total CS. These results indicated a high incidence of MAP, as a result of high rates of CS. Conclusion: morbidly adherent placenta was highly associated with the existence of placenta previa, especially in cases with previous cesarean section. When morbidly adherent placenta was diagnosed or suspected antenatally, the patient must be referred to a tertiary center. Generally, the recommended management is cesarean hysterectomy. However, this approach might not be considered first-line treatment for women who have a strong desire for future fertility. Therefore surgical management of morbidly adherent placenta may be individualized.

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