Fetal and Maternal Outcomes in Cases of Morbidly Adherent Placenta in Benha University Hospital: A prospective Study

Background: Morbidly Adherent Placenta is the greatest challenge in modern obstetrics. It is severe pregnancy complication, associated with massive obstetrical hemorrhage and high maternal mortality. This work aimed to study the maternal and fetal outcomes in cases of morbidly adherent placenta for better management of these cases and to know our local practices toward these cases. Methods: This prospective cross sectional study, include 100 Singleton pregnant Third trimester Aged > 18 years old, pselected from attendee of Obstetrics and Gynecology clinics and emergency department at Benha University Hospitals. All included patients was subjected to detailed History taking, general examination, Local abdominal examination, Routine laboratory investigations, Radiological examination include Trans-abdominal ultrasound and Colored Doppler. Results: The findings of ultrasonography done for antenatal diagnosis of MAP cases. Most of the patients (53 cases, 53%) had complete centralis placenta, 97% showed US findings suggestive of invasion, 65% had loss of retroplacental zone of cleavage scale. the results of Doppler study (increased placental vasculature), that was increased among 73% of studied cases and 27% were normal that only 45 cases (6.6%) suspected to have MAP and had MRI done, showing 64.4% prevalence of placenta accrete among them, 13.3% placenta increta and 22.2% percreta. Mean operative time was 3.16 ± 0.94 hours. The mean of blood loss was 2133 ± 188.7 ml (500-9000) and 72% of MAP separated manually, while 24% failed to be separated. Conclusions: In cases of morbidly adherent placenta, placental localization, CS, and Increased placental vasculature affect the maternal and fetal outcomes.