Frequency Of Morbidly Adherent Placenta In Pregnant Women With Previous Uterine Scar.
DOI:
https://doi.org/10.69980/ajpr.v28i5.807Keywords:
Placenta Accreta, Cesarean Section, Uterine Scars, Placenta PreviaAbstract
Objective: To evaluate the occurrence of morbidly adherent placenta (MAP) among women in pregnancy who had already scarred uterus, and to measure the risk factors related to it.
Methodology: This is a cross-sectional study that was carried out at the Department of Obstetrics and Gynaecology, Liaquat National Hospital, Karachi. Non-probability consecutive sampling was used to enroll 163 pregnant women aged 20-55 years and with singleton pregnancies who had a history of uterine surgery. Patients with renal and other acute abdominal diseases were not included. Doppler ultrasonography was used to diagnose MAP and its types (accreta, increta, percreta). It was done on a structured proforma and analyzed through SPSS version 21. Associations were measured using Chi-square and Fisher's Exact tests; p ≤0.05 was taken as statistically significant.
Results: The frequency of MAP was 11.0%. Placenta accreta was the most common type (4.9%), followed by increta (3.7%) and percreta (2.5%). MAP was significantly associated with placenta previa (p = 0.008), parity ≥3 (p = 0.048), and preterm delivery <37 weeks (p = 0.001). No significant association was found with age group, BMI, previous cesarean section, myomectomy, or scar duration.
Conclusion: Morbidly adherent placenta is a prevalent and serious condition in women with prior uterine scarring. The presence of placenta previa, higher parity, and preterm delivery are strong predictors. Early detection and risk-based prenatal surveillance are essential for improving maternal and fetal outcomes, especially in high-risk obstetric populations.
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