Placenta Accreta Incidence and Outcome of Management in Al-Yarmouk Teaching Hospital
Abstract
ABSTRACTBackground: Maternal mortality rate of 7% has been quoted for the disorders of placentation, which are important conditions with significant problems at delivery because of incomplete placental separation.
Objective: To study the incidence of placenta accreta in Al-Yarmouk Teaching Hospital, characteristics of the patients and the outcome of the management.
Method: A retrospective study of medical records, to identify all patients with placenta accrete, was conducted at Al-Yarmouk Teaching Hospital. The study included all patients diagnosed during the period from August 2008 to the end of December 2009. Diagnosis of placenta accreta was based on clinical and histological findings.
Results: In the study period, there were 16640 deliveries at AL-Yarmouk Teaching Hospital, of which 266 stillbirths. Thirty eight patients had placenta accreta. The overall incidence of placenta accreta was 1:438, pathologically confirmed in 30 patients (78.9%); 26 patients (68.4%) with accrete and 4 patients (10.5%) with inccreta. In 92% of patients, the plan was cesarean hysterectomy from the start. Attempts to preserve the uterus were adopted in 3 patients only, but the uterus was preserved in one patient only. No maternal mortality was reported among the studied group, while there were 5 perinatal mortality. Almost all the patients received blood transfusion, in 52.6%; the transfusion was massive (more than 5 units of blood). Twelve patients had urological complications. Ligation of internal iliac artery was done in 13 patients (34%).
Conclusion: Al-Yarmouk teaching Hospital, as tertiary center, reported an incidence of placenta accreta comparable, if not exceeds that one reported worldwide. The absence of recent diagnostic tools and management options had negative impact on the outcome, especially in term of fertility preservation.
Keywords: Placenta accreta, Incidence, Management.
Iraqi Medical Journal Vol. 56, No.1, June 2010; p.69-74
Copyright (c) 2017 Iraqi Medical Journal
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