Conservative manage men t of morbidly
adherent placenta is defined as all the procedures or strategies that aim to avoid peripartum hysterectomy and its related morbidity and consequences.
Morbidly
Adherent Placenta (MAP), a dreaded obstetric complication that has risen to an alarming rate over the last two decades paralleling the rise of caesarean deliveries1.
Prediction of morbidly
adherent placenta using a scoring system.
Rice et al., "Morbidly
adherent placenta treatments and outcomes," Obstetrics & Gynecology, vol.
MAP, morbidly
adherent placenta; MRI, magnetic resonance imaging; CS, cesarean section.
[9] A history of previous cesarean delivery plays a major role in this surgery as it can lead to both ruptured uterus and morbid
adherent placenta.
Ultrasound was performed prior to the procedure to localize the placenta and to check the degree of the
adherent placenta. Once the abdomen was opened, direct visualization of the anterior uterine wall was carried out, and further incision plan should be made.
The most common indication of EOH in our study was uterine atony (25%) followed by morbidly
adherent placenta (21%) and uterine rupture (17%).
During the study period there were no laid down standard conservative or extirpative protocols for the management of morbidly
adherent placenta. Cases were judged and treated on the choice of consultants.
Ultrasonographic evaluation of uteroplacental blood flow patterns of abnormally located and
adherent placentas. Am J Obstet Gynecol 1990;163:723-7.
Conclusion: Uterine atony and morbidly
adherent placenta were the main reasons for emergency obstetric hysterectomy (EOH) in our set up.
Once a rare occurrence, morbidly
adherent placenta is now becoming an increasingly common complication of pregnancy, mainly due to the increasing rate of caesarean delivery over the past years and also intrauterine procedures like dilatation and curettage, previous surgeries etc.
