Management, Complications and Outcomes of 14 Cases of Cesarean Scar Pregnancy in a Tertiary Care Hospital in Sri Lanka

Abstract

Morbidly adherent placenta (MAP) is an umbrella term used to refer to abnormally invasive placentation further divided as placenta accrete, increta and percreta. In the presence of MAP, normal placental separation may fail to occur leading to increased perpartum blood loss and hysterectomy. With the increase in cesarean deliveries, the main risk factor for MAP, the incidence of the condition has increased and likely continue to do so in the near future. In this case series we describe the management and outcomes of 14 patients with MAP presenting to a single unit at a tertiary care hospital in Sri Lanka. Antenatal diagnosis using history and ISUOG ultrasound diagnostic criteria, preparation of detailed management plans in accordance with latest international recommendation and close supervision of the Consultant Obstetrician during operative management were the mainstays of management. Through this, the unit was able to maintain 100% maternal survival.