Maternal Outcomes in the Management of Morbidly Adherent Placenta: Multidisciplinary Team vs. Standard Care at a Tertiary Care Hospital

Abstract

Background: Morbidly adherent placenta (MAP) is one of the obstetric emergencies, if not diagnosed and managed properly.

Objective: The objective of the study was to compare maternal outcomes in patients with morbidly adherent placenta managed in a multidisciplinary team setting compared to standard care.

Study type, settings & duration: A comparative cross-sectional study was conducted in obstetrics and gynecology Department, Liaquat University of Medical and Health Sciences for a period of two years from June 2018 to May 2020.

Methodology: A total of 40 patients were enrolled, using convenient sampling technique. All patients either booked, un-booked, referral or who came as emergency cases with morbidly adherent placenta (including Accreta, Increta, Percreta) confirmed on TVS, MRI or clinically diagnosed during surgery were included in study. A questionnaire was used to retrieve the required data for statistical analysis. Chi-square test was applied and p-value ≤ 0.05 considered as level of significance.

Results: Twenty study participants (50%) were booked cases and ante-natally diagnosed cases of MAP and 60% of them were admitted in the hospital, most of them were in the age group 20-30 years and all (100%) had history of previous caesarean section. Almost 88% were at or more than 35 weeks of pregnancy. Around 48% Percreta, 27% Accreta and 25% Increta types of MAP were found during surgical procedure. Out of 40 enrolled patients 26 (65%) were managed by multidisciplinary care while 14 (35%) by Standard care. ........