Characteristics of Patients with Morbidly Adherent Placenta at Dr. Hasan Sadikin Hospital Bandung

Muhammad Alamsyah Aziz,(1*) Dewi Retno Wulandari,(2)

(1) Department of Obstetrics and Gynecology Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung
(2) Department of Obstetrics and Gynecology Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung
(*) Corresponding Author


Objective: Morbidly adherent placenta (MAP) is one of the causes of postpartum haemorrhage that impacts morbidity, hysterectomy, and mortality. This study reviewed patient characteristics and disease features in tertiary referral hospital patients with MAP.
Methods: This is a quantitative descriptive study conducted on patients with MAP in September 2019–September 2020. Patient data were sourced from medical records. The characteristics described in this study include sociodemographic characteristics, obstetric history (gestation, parity, and abortion), history of caesarean section (CS), history of curettage, comorbidities, and current disease description and outcomes (bleeding, infant outcome, length of stay, death).
Result: A total of 24 patients were diagnosed post-operatively as MAP in this study. Most of the patients were multi-parity, had a history of CS or curettage, and had comorbid placenta previa. Most of the patients came for CS plans or went with the chief complaint of bleeding. All patients were managed by hysterectomy. There was one case of maternal death and one case of fetal death.
Conclusion: The characteristics of the patients in this study reflect the risk factors and general features of MAP.

Karakteristik Pasien MAP di RSUP Dr. Hasan Sadikin Bandung

Tujuan: Morbidly adherent placenta (MAP) merupakan salah satu penyebab perdarahan pasca-salin yang berdampak pada morbiditas, tindakan histerektomi, dan mortalitas. Penelitian ini dilakukan untuk meninjau karakteristik pasien dan gambaran penyakit pada pasien dengan MAP di rumah sakit rujukan tersier.
Metode: Penelitian ini merupakan deskriptif kuantitatif yang dilakukan pada pasien dengan MAP pada September 2019–September 2020. Data pasien bersumber dari rekam medik. Karakteristik yang dideskripsikan pada penelitian ini meliputi karakteristik sosiodemografi, riwayat obstetrik (gestasi, paritas, dan abortus), riwayat seksio caesarea (SC), riwayat kuretase, komorbid, dan gambaran penyakit terkini serta luarannya (perdarahan, luaran bayi, lama perawatan, kematian).
Hasil: Sebanyak 24 pasien yang terdiagnosis pasca-bedah sebagai MAP pada penelitian ini. Sebagian besar pasien multi paritas, memiliki riwayat SC ataupun kuretase, dan memiliki komorbid plasenta previa. Sebagian besar pasien datang untuk rencana SC ataupun datang dengan keluhan utama perdarahan. Semua pasien ditatalaksana dengan histerektomi. Kematian pada ibu terjadi sebanyak satu kasus dan anak terjadi sebanyak satu kasus.
Kesimpulan: Karakteristik pasien pada penelitian ini merefleksikan faktor risiko dan gambaran umum MAP.
Kata kunci: morbidly adherent placenta, plasenta akreta, plasenta inkreta, plasenta perkreta.


morbidly adherent placenta; placenta accreta; placenta increta; placenta percreta

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Bauer, S. T. & Bonanno, C. Abnormal Placentation. Seminars in Perinatology 33, 88–96 (2009).

Bajwa, S. K., Singh, A. & Bajwa, S. J. S. Contemporary issues in the management of abnormal placentation during pregnancy in developing nations: An Indian perspective. International journal of critical illness and injury science 3, 183–9 (2013).

Chaudhari, H. K., Shah, P. K. & D’Souza, N. Morbidly Adherent Placenta: Its Management and Maternal and Perinatal Outcome. The Journal of Obstetrics and Gynecology of India 67, 42–47 (2017).

Comstock, C. & Bronsteen, R. The antenatal diagnosis of placenta accreta. BJOG: An International Journal of Obstetrics & Gynaecology 121, 171–182 (2014).

Valentini, A. L. et al. The morbidly adherent placenta: when and what association of signs can improve MRI diagnosis? Our experience. Diagnostic and Interventional Radiology 23, 180–186 (2017).

Kayem, G., Deneux-Tharaux, C. & Sentilhes, L. PACCRETA: Clinical situations at high risk of Placenta ACCRETA/Percreta: impact of diagnostic methods and management on maternal morbidity. Acta Obstetricia et Gynecologica Scandinavica 92, 476–482 (2013).

Zhong, L., Chen, D., Zhong, M., He, Y. & Su, C. Management of patients with placenta accreta in association with fever following vaginal delivery. Medicine 96, e6279 (2017).

Ju, W. & Kim, S. C. Placenta increta after first-trimester dilatation and curettage manifesting as an unusual uterine mass: magnetic resonance findings. Acta Radiologica 48, 938–940 (2007).

Fitzpatrick, K. E. et al. Incidence and Risk Factors for Placenta Accreta/Increta/Percreta in the UK: A National Case-Control Study. PLoS ONE 7, e52893 (2012).

Feharsal Y, L. Y. P. S. K. O. A. T. N. N. et al. Clinical Characteristics and Risk Factors Analysis for Severity of Morbidly Adherent Placenta at Persahabatan General Hospital in 2015-2018. J Indones Med Assoc (2019).

Piñas Carrillo, A. & Chandraharan, E. Placenta accreta spectrum: Risk factors, diagnosis and management with special reference to the Triple P procedure. Women’s Health 15, 174550651987808 (2019).

Bartels, H. C., Postle, J. D., Downey, P. & Brennan, D. J. Placenta Accreta Spectrum: A Review of Pathology, Molecular Biology, and Biomarkers. Disease Markers 2018, 1–11 (2018).

Jauniaux, E. et al. FIGO consensus guidelines on placenta accreta spectrum disorders: Prenatal diagnosis and screening,. International Journal of Gynecology & Obstetrics 140, 274–280 (2018).

Garmi, G. & Salim, R. Epidemiology, Etiology, Diagnosis, and Management of Placenta Accreta. Obstetrics and Gynecology International 2012, 1–7 (2012).



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