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International Scientific Indexing (ISI) Indexed Journal Applied Medical Research ISSN: 2149 - 2018
Applied Medical Research. 2021; 8(2):(122-136)


Frequency of Morbidly Adherent Placenta in Previous Scarred Uterus

Naushaba Rizwan*, Faiza Saleem and Syed Farhan Uddin

Abstract
Objective: To determine the frequency of morbidly adherent placenta in previous scarred uterus in tertiary care hospital. Methods Study Design: Cross sectional Study Setting: Department of Obstetrics & Gynaecology- Unit- III , Liaquat University Hospital Hyderabad. Sample Size: By using prevalence of placenta increta P= 13% margin of error(d)= 6% the calculated sample size is 121 patients with the help of WHO software for sample size calculation taking 95% confidence interval. Sample Technique: Non- probability consecutive sampling. Inclusion Criteria 1. Patient of age between 20-40 years irrespective of gestation age or parity. 2. Patient with previous cesarean section. 3. Patient with previous myomectomy on the basis of history. 4. Patient with previous hysterotomy on the basis of history. Exclusion Criteria 1. All patient undergoing vaginal deliveries 2. Primigravida with placenta previa Subject and Methods: A total of 121 patients with previous caesarean section, myomectomy and hysterectomy on the basis of history were included in this study. The outcome was assessed by observing morbidly adherent placenta during cesarean section , by antenatal record of patient’s ultrasound for fetal wellbeing and doppler ultrasound. All information was kept in pre-designed proforma and was analyzed through SPSS version 21. Frequency and percentage computed for qualitative variable like previous uterine surgery, morbidity adherence placenta, placenta increta, placenta accreta & placenta percreta. Mean ±SD was calculated for qualitative variable i.e age, gestational age, gravida, and para. The stratification was done on age, gestational age, gravida, para and previous uterine surgery to see the effect of these modifiers on outcome using Chi-square test . P≤0.05 was considered as significant. Results: The average age of the patients was 30.26±4.66 years. Frequency of morbidly adherent placenta (MAP) in previous scarred uterus was observed in 9.09% (11/121) women. Out of 11 MAP cases 6(54.55%) had accreta, 3(27.27%) percreta and 2(18.18%) had increta. Conclusion: Antenatal care needs to be improved and morbid adherence of placenta should be diagnosed at the earliest possible time. Caesarean section should be minimized to reduce the risk morbidly adherent placenta.