Interpregnancy Interval in Placenta Previa With Morbidly Adherent Placenta [15O

Abstract

INTRODUCTION: To evaluate whether there is a difference in interpregnancy interval between women diagnosed with placenta previa and morbidly adherent placenta (MAP) and those with placenta previa without MAP. METHODS: Retrospective case-control study of women with previous cesarean delivery and index pregnancy complicated by placenta previa. Cases had pathology proven MAP (n=39). Controls (n=39) without MAP were matched by number of previous cesarean deliveries. Primary outcome was the interpregnancy interval. A number of secondary maternal and neonatal outcome were also recorded. Data were reported as mean ± SD, median (IQR) and rates. Comparisons and adjustments were made using t-test, Mann Whitney U test, chi square test, ANCOVA and multinomial logistic regression. RESULTS: Median interpregnancy interval was 42 (20, 60) months in the placenta previa with MAP group and 43 (24, 86) months in the placenta previa without MAP group (P = NS). Gestational age at delivery and birth weight were lower in the MAP group (P < 0.001) with a significant increase in RDS rate. As expected, gravidity and parity were higher in the MAP group (P < 0.001). In the same group, the median estimated blood loss and use of blood products at delivery were higher and the hospital stay longer. CONCLUSION: In contrast to similar previous publications, we placed special emphasis on the use of comparable populations as cases and controls. Another strength of our study is case ascertainment, limiting the cases to women who underwent hysterectomy. Our data do not suggest an association between interpregnancy interval and MAP in women with placenta previa.