Morbidly adherent placenta: a critical review.
OBJECTIVE
To evaluate the demographic profile, high risk factors, fetomaternal outcome and management options in morbidly adherent placenta (MAP).


METHODS
Retrospective analysis.


METHODS
Review of 20 case records of women with MAP during year 2001-2006.


RESULTS
The mean age and parity of the women was 27.7 ± 4.2 years and 2.5 respectively. 70 % women had previous uterine scar, and similar number had placenta previa. 60 % women presented with antepartum hemorrhage and 20 % with retained placenta. 85 % women underwent hysterectomy with 5 % requiring internal iliac artery ligation, another 5 % partial cystectomy and 15 % bladder repair. Blood loss was between one and nine litres requiring an average of six units whole blood and 4 units FFP. There were six (30 %) maternal deaths. 55 % of the newborns were preterm and the perinatal mortality was 33.3 %.


CONCLUSIONS
Cesarean section and placenta previa are significant risk factors. MAP is associated with high fetomaternal morbidity and mortality.
Department of Obstetrics & Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, 110095 India  ; KL-99, Kavi Nagar, Ghaziabad, UP 201002 India.
Richa
R
Aggarwal
Amita
A
Suneja
Neelam Bala
NB
Vaid
Ponam
P
Yadav
Abha
A
Sharma
Kiran
K
Mishra
Internal iliac artery ligation; Morbidly adherent placenta; Placenta accreta; Placenta increta; Placenta percreta