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

Muhammad Alamsyah Aziz, Dewi Retno Wulandari


Abstract


Abstract
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

Abstrak
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.


Keywords


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

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DOI: http://dx.doi.org/10.24198/obgynia.v6i1.413

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