Placenta accreta : rate, maternal and neonatal outcomes esperience at Moewardi District Hospital, Surakarta, Indonesia : a prospective study
Affi Ratnasari (ID), Eric Yuliantara (ID), Wisnu Prabowo (ID)
[Ratnasari] Moewardi District Hospital,Surakarta,Indonesia , [Yuliantara] Moewardi District Hospital,Surakarta,Indonesia, [Prabowo] Moewardi District Hospital,Surakarta,Indonesia
Objective: The aim of this study is to evaluate prevalence and maternal and neonatal outcomes among women with placenta accreta Methods: A prospective descriptive study of 9 singleton pregnancies with placenta accreta was evaluated in this study. The study was conducted at Moewardi District Hospital, Surakarta, Indonesia from January through December 2016. Outcomes measures: including prevalence of placenta accreta, maternal and neonatal outcomes, and case-fatality rate. Result: There were 1679 deliveries performed during the study period, of them, 9 cases were placenta accreta. Thus, the prevalence of placenta accreta was 0,54%. About 66,7% (n=6) had one previous caesarean history, while 33,7% (n=3) underwent two previous caesarean history. Of women with placenta accreta, 77,8% (n=7) were presented with antepartum haemorrhage, and 88,9% (n=8) of women need pre-operative transfusion due to anemic level of hemoglobin. About 77,8% (n=7) were having delivery in fullterm pregnancies, while 22,2% (n=2) were having delivery in preterm pregnancies. All of the babies (100%) were delivered with good apgar score. Unfortunately, all of the women (100%) need hysterectomy to override bleeding complication along the delivery. From all of the hysterectomy procedure that was performed, three cases (33,3%) was complicated with bladder injury. The mean of intraoperative bleeding was 3655±2248 cc of blood, while the mean of post operative transfusion was 2788 ± 2493cc. There was no maternal death in this study. Conclusion: Placenta accreta has caused serious morbidity related to hemorrhage in recent condition and fertility problems in the future. All of the patients had hysterectomy although majority of the patients only had one previous caesarean history before having placenta accreta. Conservative management need to be evaluated in cases with placenta accreta.