Morbidly Adherent Placenta Treatments and Outcomes
Year: 2015
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To describe recent maternal and neonatal delivery outcomes among women with a morbidly adherent placenta in major centers across the United States. METHODS: This study reviewed a cohort of 115,502 women and their neonates born in 25 hospitals in the United States between March 2008 and February 2011 from the Assessment of Perinatal EXcellence data set. All cases of morbidly adherent placenta were identified. Maternal demographics, procedures undertaken, and maternal and neonatal outcomes were analyzed. RESULTS: There were 158 women with a morbidly adherent placenta (1/731 births, 95% confidence interval 1/632-866). Eighteen percent of women with a morbidly adherent placenta were nulliparous and 37% had no prior cesarean delivery. Only 53% (84/158) were suspected to have a morbidly adherent placenta before delivery. Women with a prenatally suspected morbidly adherent placenta experienced large blood loss (33%), hysterectomy (92%), and intensive care unit admission (39%) compared with 19%, 45%, and 22%, respectively, in those not suspected prenatally to have a morbidly adherent placenta (P<.05 for all). CONCLUSION: Eighteen percent of women with a morbidly adherent placenta were nulliparous. Half of the morbidly adherent placenta cases were suspected before delivery and outcomes were poorer in this group, probably because the more clinically significant morbidly adherent placentas are more likely to be suspected before delivery. LEVEL OF EVIDENCE: : II.
Source: Obstetrics and Gynecology
Institutions: Northwestern University, Memorial Hermann, University of Utah, Brown University, University of Alabama at Birmingham, MetroHealth Medical Center, The Ohio State University, Case Western Reserve University, Columbia University, The University of Texas Southwestern Medical Center, The University of Texas Health Science Center at Houston, George Washington University, Eunice Kennedy Shriver National Institute of Child Health and Human Development, The University of Texas Medical Branch at Galveston
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1216570417, G1648937940, Maternal Fetal Medicine Network: Data Coordinating Cent*, G1882602020, Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network, Maternal Fetal Medicine Units Network, G2254024324, Case Western Reserve University/Cleveland Clinic CTSA (UL1), NICHD Maternal Fetal Medicine Units Network, G2594613454, NICHD Maternal-Fetal Medicine Units (MFMU) Network, G284963502, G29782494, Maternal-Fetal Medicine Units Network, NICHD Maternal Fetal Medicine Units Network, Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network, Cooperative Multicenter Maternal Fetal Medicine Units Networks, G3786447104, University of Utah Center for Clinical and Translational Science-UL1, G4027080872, G4238721334, Co-Operative Multicenter Trials in Obstetrics & Maternal Fetal Medicine, Data Coord Ctr-NICHD Cooperative Multicenter Maternal Medicine Units Research Net, Multicenter Network of Maternal Fetal Medicine Units, G4657398957, G50908112, Maternal Fetal Medicine Units Network, Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network (U10), G6657596466, G673807916, Brown/WIH Eunice Kennedy Shriver NICHD MFM Units Network Site, Maternal Fetal Medicine Network, NICHD Maternal Fetal Medicine Units Network, NICHD Materal Fetal Medicine Units Network, Clinical and Translational Science Collaborative of Cleveland, UofU Maternal-Fetal Medicine Units (MFMU) Network: Clinical Centers, NICHD Maternal-Fetal Medicine Units (MFMU) Network: Data CoordinatingCenter, Brown University/Women & Infants Hospital of Rhode Island (WIH) Center Application for the Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network, Maternal Fetal Medicine Units Network - Northwestern Study Center, Maternal-Fetal Medicine Units (MFMU) Network, Case Western Reserve University Center of the NICHD MFMU Network, Columbia University Maternal-Fetal Medicine Units Network Clinical Center, NICHD maternal fetal medicine units network, UNC MFMU: Advancing Perinatal Health via Definitive, Multi-Site Clinical Studies, Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units (MFMU) Network (UG1), G922324195
OpenAlex ID: W1971792978