Prenatal diagnosis and delivery related bleeding in cases with abnormally invasive placenta

Abstract

Introduction Abnormally invasive placenta (AIP) defines as abnormal placental attachment to the uterine wall. It is determined by the severity of the attachment – direct trophoblast attachment to the uterine myometrium (placenta accreta (PA)), partial invasion through the uterine wall (placenta increta (PI)) or invading into the adjacent viscera (placenta percreta (PP)). Not detected AIP can lead to severe bleeding and result in high risk mortality and morbidity to both mother and child. Material and Methods This retrospective study includes an analysis of 134 women who gave birth and were diagnosed with AIP in Lithuanian University of Health Sciences Kaunas Clinics (LUHS KC) from 2015 to 2017. Data was analyzed using MO Excel and IBM Statistics SPSS for frequencies and chi – square test. Results with values of p < 0.05 were considered as statistically significant. Results AIP was diagnosed to 1.37 % (n = 134) of women, who gave birth at LUHS KC from 2015 to 2017 (n = 9797). 90.29 % (n = 121) of the patients were diagnosed with PA, 6.72 % (n = 9) with PI and 2.99 % (n = 4) with PP. 17.16 % (n = 23) of the AIP were diagnosed by ultrasound. 26.12 % (n = 35) of women had a prior surgical intervention. 16.42% (n = 22) had a prior C-section. Women who had previous gynaecological interventions were diagnosed with PA (p = 0.012) and PP (p = 0.037) more frequently. 69.40 % (n = 93) of the patients gave birth naturally and 30.60 % (n = 41) had a C-section (n = 18 planned, n = 23 urgent).[...].