Morbidly Adherent Placenta Treatments and Outcomes
Open accessAbstract
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.
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Population studies have shown that placenta accreta spectrum remains undiagnosed before delivery in one-half to two-thirds of cases.
“Population studies have shown that placenta accreta spectrum remains undiagnosed before delivery in one-half 136 to two-thirds of cases.120”
From Placenta Praevia and Placenta Accreta: Diagnosis and Management: Green‐top Guideline No. 27a (2019) · cites this paper as [136]
Citation 120 is attached to the two-thirds figure, but the Results report that 53.2% of cases were suspected before delivery, leaving 46.8% unsuspected. The Discussion likewise says about half were suspected. This source supports an undiagnosed proportion near one-half, not two-thirds. (LLM, conf=0.88)
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- Authors
- Bailit, J. L., Grobman, W. A., Rice, M. M., Reddy, U. M., Wapner, R. J., Varner, M. W., Leveno, K. J., Iams, J. D., Tita, A. T. N., Saade, G., Rouse, D. J., & Blackwell, S. C.
- Affiliations
- Northwestern University (US)
- George Washington University (US)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (US)
- Columbia University (US)
- University of Utah (US)
- The University of Texas Southwestern Medical Center (US)
- The Ohio State University (US)
- University of Alabama at Birmingham (US)
- The University of Texas Medical Branch at Galveston (US)
- Brown University (US)
- Memorial Hermann (US)
- ORCID
- Venue
- Obstetrics & Gynecology
- Published
- 2015-03
- Volume
- 125
- Issue
- 3
- Pages
- 683-689
- ISSN
- 0029-7844 (ISSN-L)
- PMC
- PMC4347990
- OpenAlex
- W1971792978
- Cited by
- 313
- References
- 8
- Citations by year
- 2026: 19 · 2025: 18 · 2024: 38 · 2023: 42 · 2022: 39 · 2021: 41 · 2020: 27 · 2019: 25 · 2018: 30 · 2017: 19 · 2016: 11 · 2015: 3
- FWCI
- 20.92
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000439)
- National Center for Research Resources (UL1RR024989, UL1RR025764)
- National Center for Advancing Translational Sciences
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD40512, HD53118, U01HD036801, HD27917, U10HD040544, U10HD034208, HD-27915, U10HD040512, HD34116, UG1HD034116, HD40545, (HD40500, UG1HD053097, U10HD027915, U10HD040545, U10HD040560, HD 40544, HD40560, HD53097, U10HD027917, U10HD036801, U10HD021410, HD 34208, HD 36801, U10HD053097, U10HD034116, HD27869, [HD21410, U10HD040500, U10HD040485, U10HD053118, U10HD027869, UG1HD034208, U24HD036801, UG1HD040500, UG1HD040512, UG1HD027869, UG1HD040544, UG1HD040485, UG1HD027915, UG1HD040560, UG1HD040545, HD 40485)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Biochemistry › Blood transfusion and management
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- placenta accreta spectrum, placenta accreta, maternal outcomes, neonatal outcomes, hysterectomy, blood loss, intensive care unit admission, prenatal diagnosis, nulliparity, cesarean section, perinatal outcomes
- MeSH terms
- Adult, Female, Humans, Infant, Newborn, Placenta Accreta, Pregnancy, Pregnancy Outcome, United States, Cohort Studies, Placenta, Retained
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