MATERNAL OUTCOME OF MORBIDITY ADHERENT PLACENTA

Abstract

BJECTIVE: To determine the maternal complication of morbidity adherent placenta.

METHODOLOGY: This descriptive cross-sectional study was conducted at a tertiary care hospital and included 96 pregnant women diagnosed with morbidly adherent placenta. Women aged 18-35 years with gestational age >28 weeks, diagnosed via ultrasound, were enrolled through outpatient and emergency admissions. Demographic, obstetric, and clinical variables were recorded. Quantitative variables were assessed for normality using the Shapiro-Wilk test. Mean ± SD or median (range) were calculated accordingly. Frequencies and percentages were computed for categorical variables. Stratification was performed, and Chi-square or Fisher’s exact test was applied. A p-value <0.05 was considered statistically significant.

RESULTS: The mean maternal age was 29.4 ± 4.2 years, and mean gestational age was 35.8 ± 2.6 weeks. Most patients were un-booked (56.3%), from rural areas (60.4%), and had a history of previous cesarean section (75%). Cesarean section was the mode of delivery in 91.7% cases. The most common complications were blood transfusion (85.4%), cesarean hysterectomy (60.4%), prolonged hospital stay (50%), and ICU admission (37.5%). Maternal mortality was observed in 6.3% cases. Significant associations were found between cesarean hysterectomy and previous cesarean section (p=0.01) and parity (p=0.002). Blood transfusion was associated with un-booked status (p=0.03), while ICU admission was associated with emergency admission (p=0.04) and lower educational status (p=0.01).

CONCLUSION: Morbidly adherent placenta is associated with high maternal morbidity and mortality. Early diagnosis, improved antenatal care, and timely referral are essential to reduce adverse outcomes