Catastrophic Maternal Complications of Morbidly Adherent Placenta in Patients with History of Previous Caesarean Delivery

Abstract

Objective:The study is aimed to describe the grave maternal outcomes encountered in patients having morbidly adherent placenta along with history of previous caesarean section. Materials and Methods: This was a cross-sectional study from September 2014 to August 2015. All the patients attended in the in-patient department of obstetrics & gynaecology in DMCH during the study period having morbid adhesion of placenta (diagnosed antenatally by USG or diagnosed preoperatively) along with history of previous caesarean section. Result: Total 10,805 obstetric patients delivered during the study period, of which 6,337 patients had caesarean sections. Out of them 37 pregnant patients were found to have morbid adhesion of placenta along with history of previous C/S. The incidence is 1 in 292 deliveries. All of the 37 patients needed hysterectomy for intractable per operative haemorrhage. All the patients needed transfusion of more than 04 units of blood. Nineteen patients needed ICU supports Ten (27%) patients died. Other grave complications were hypovolemic shock (19 patients), bladder injury (16patients), renal failure (07 patients), multiorgan failure (07 patients) and DIC (06 patients). Conclusion: All the patients of morbidity adherant placenta with previous Caesarean Section needed caesarian hysterectomy and ten patients died.