Placenta Accreta: Five-Year Experience at a Tertiary-Care Center

Abstract

Abstract

Objective: The goals of this analysis were (1) to evaluate the demographic profiles, high risk factors, fetomaternal outcomes, and management options for patients with placenta accreta, and (2) to plan future strategies for managing this condition. Materials and Methods: This retrospective analysis involved a review of 17 case records of women with placenta accreta from January 2007 to December 2011. Results: The mean age of the patients was 27.2±3.8 years, and 7.6% of these women were grandmultiparous. Fourteen women (82.35%) had previous caesarean section scars and 11 women (64.7%) had scarred uteri with placenta previa. Twelve women (70.5%) presented antenatally with antepartum hemorrhage. Fourteen women have operative procedures performed on an emergency basis, and the remaining 3 women were scheduled for elective surgery. Seven of 17 women (41.7%) underwent hysterectomy. The remaining 10 patients (58.82%) were managed conservatively. Bladder injury during dissection occurred in 5 patients (29.4%). Massive blood loss was a prominent feature of this condition, with a mean blood loss of 2.8 L. There was 1 (5.8%) maternal mortality. The average gestational age was 35.4 weeks. Sixty percent of the neonates were preterm, with an average birth weight of 2.1 kg. Perinatal mortality was 35%. Conclusions: Cesarean section and placenta previa are significant risk factors for placenta accreta. This condition is associated with high fetomaternal morbidity and mortality. (J GYNECOL SURG 30:91)