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Category: Volume 05 Issue 10 October 2017
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Title: Tackling Caesarean Scar Pregnancy to Target Morbidly Adherent Placenta Previa– A Viable Option?

Authors: Dr S.Sreelatha, Dr. Manjula M

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i10.91

Abstract

Introduction: The late consequences of lower segment caesarean delivery namely scar pregnancy and morbidly adherent placenta in the lower uterus were thought to be two separate entities.  Recently few studies have shown them to be a continuum.

Aim of the study was to analyse the clinical features, associations and the morbidity pattern of scar pregnancy and morbidly adherent placenta previa in pregnancies following caesarean delivery. Methodology – This was a descriptive study conducted in the Department of O&G, Government Medical College Thiruvananthapuram from January to December 2016. All cases diagnosed as CSP and MAPP were included.

Results: There were 8 caesarean scar pregnancy cases and 14 morbidly adherent placenta previa cases in our study. Regarding previous obstetric details, one significant finding was that in all cases where the indication for previous CS was known (72.7%), caesarean delivery was conducted before the onset of active labour. Maternal morbidity was significantly high in MAPP when compared to CSP

Conclusion: As MAPP is considered a continuum of CSP and is definitely more morbid than CSP it is better to diagnose and tackle CSP at an early gestation at least in a subset of women who wishes not to continue a high risk pregnancy.

Keywords: caesarean scar pregnancy, morbidly adherent placenta previa

Abbreviations: CSP – caesarean scar pregnancy, MAPP – morbidly adherent placenta previa, USS – ultra sound scan MRI- magnetic resonance imaging.

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Corresponding Author

Dr Manjula M

Assistant professor, Dept. of O & G, SAT Hospital,

Govt. Medical College, Trivandrum