الفهرس 
MORBIDLY ADHERENT PLACENTAOnly 14 pages are availabe for public view
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Abstract
Background: Morbidly Adherent Placenta (MAP) is associated with considerable maternal morbidity and potential mortality. Increased rate of MAP among young age patients or patients with low parity makes the conservative surgery sometimes desirable. There’s a concern as regards conservative surgery and future pregnancy outcomes.
Objective: Estimation of the short- and long-term outcomes after successful conservative surgery for MAP at Ain Shams University Maternity Hospital during 5-year period, from January 2017 to December 2021.
Patients and Methods: During this retrospective study, 47 women with MAP diagnosed by 2D and power Doppler that was confirmed intraoperatively were enrolled. Women included in this study were patients with successful conservative surgery. The notes about them were carefully studied as regards to future fertility and pregnancy outcomes and incidence of urological and intestinal injury, ICU admission, blood loss, blood transfusion and complications.
Results: Our study revealed that 40.4% of cases had contraception; tubal ligation (12.8%), hormonal contraception (17.0%) and lactational amenorrhea (10.6%). 59.6% of cases sought for pregnancy; only 8 cases got pregnant (28.6%). 5 cases reached term delivery; Two of them had MAP, one case had Preterm labor, two cases had abortion. No Ectopic pregnancy or Rupture of uterus had occurred. 59.6% of neonates needed NICU admission, Neonatal mortality was infrequent (4.3%). 34.0% of cases delivered neonates with low birth weight. 76.6% of cases had preterm birth.
Conclusion: In facilities with the necessary tools and resources, conservative surgery for placenta accreta may help women avoid hysterectomy and has less maternal morbidity. It may be an alternative to hysterectomy.