Role of Timed Hysterectomy in Lowering Morbidity and Mortality of Morbidly Adherent Placenta

Authors

  • Najma Bano Shaikh
  • Sajida Yousfani
  • Nabila Hassan
  • Sabreena Abbas
  • Fouzia Shaikh

Abstract

Objective: To describe the method of reducing morbidity and mortality among women with morbidly adherent placenta who ended up in hysterectomy.

Methodology: This retrospective descriptive case series study included twenty pregnant women with morbidly adherent placenta who needed hysterectomy and managed by team approach at Gynae unit I, Liaquat University of Medical and Health Sciences hospital Hyderabad from January 2019 to February 2020. Data was collected with respect to age, parity, gestational age, booking status, number of previous caesarean section, clinical presentation, time of diagnosis and maternal outcomes. Analysis was through SPSS program version 21. Frequency, percentages, means ± standard deviation was calculated for various variables.

Results: The frequency of morbidly adherent placenta (MAP) was found in 1 in 308 births. The mean age was 29.55±4.62years. The mean parity and gestational age was3.1±1.58 and 33.2±5.02 weeks respectively. All had one or more than one previous cesarean section with   90% had associated placenta previa. Half of the cases presented with ante partum hemorrhage, and had placenta accrete. Emergency surgery was required in 65% of the cases.  Hypovolemic shock (45%), bladder injury (20%) was observed as main complications. Mean blood loss was 1.72±0.75 liters; mean blood transfusion of 3.6±1.31 units with mean hospital stay of 7.70±4.47 days, there was 1mortality (5%) in the study.

Conclusion: Preoperative confirmed diagnosis, anticipation of high-volume blood transfusion, early recourse to hysterectomy by senior obstetrician, adapting team approach are methods of reducing morbidity and mortality in MAP.

Keywords:  Previous cesarean section, placenta Previa, morbidly adherent placenta, hysterectomy, blood Transfusion, maternal outcome

Downloads

Published

03-01-2022

How to Cite

1.
Shaikh NB, Yousfani S, Hassan N, Abbas S, Shaikh F. Role of Timed Hysterectomy in Lowering Morbidity and Mortality of Morbidly Adherent Placenta. J Liaq Uni Med Health Sci [Internet]. 2022 Jan. 3 [cited 2024 Dec. 23];20(5):289-93. Available from: http://ojs.lumhs.edu.pk/index.php/jlumhs/article/view/812

Issue

Vol. 20 No. 5 (2021): Journal of Liaquat University of Medical & Health Sciences

Section

Original Articles

License

Copyright (c) 2022 Journal of Liaquat University of Medical & Health Sciences

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Submission of a manuscript to the journal implies that all authors have read and agreed to the content of the undertaking form or the Terms and Conditions.

When an article is accepted for publication, the author(s) retain the copyright and are required to grant the publisher the right of first publication and other non-exclusive publishing rights to JLUMHS.

Articles published in the Journal of Liaquat University of Medical & health sciences are open access articles under a Creative Commons Attribution-Noncommercial - Share Alike 4.0 License. This license permits use, distribution and reproduction in any medium; provided the original work is properly cited and initial publication in this journal. This is in accordance with the BOAI definition of open access. In addition to that users are allowed to remix, tweak and build upon the work non-commercially as long as appropriate credit is given and the new creations are licensed under the identical terms. Or, in certain cases it can be stated that all articles and content there in are published under creative commons license unless stated otherwise.