The effect of placenta position on re-pregnant women with placenta previa after cesarean section

Abstract

Objective To explore the effect of the placenta position on re-pregnant women with placenta previa after cesarean section. Methods A retrospective study was conducted in 62 re-pregnant women with placenta previa after cesarean section. The patients were admitted to the First Affiliated Hospital of Sun Yat-sen University from June 2008 to June 2013. They were divided into anterior group (33 cases) and posterior group (29 cases). The patients with placenta implanted the front wall of the uterus were in the anterior group; while the others with placenta implanted the back wall of the uterus were in the posterior group. General condition, placenta position, complication, pregnancy outcomes and neonatal outcomes were analyzed using t test or Chi-square test. Results The rate of antepartum hemorrhage, postpartum hemorrhage, placenta adherence, placenta accrete, hysterectomy, disseminated intravascular coagulation, and premature birth of the two groups were 45.5% and 17.2%(χ2=4.554, P=0.033), 69.7% and 13.8%(χ2=17.348, P<0.001), 48.5% and 20.7%(χ2=4.151, P=0.042), 33.3% and 10.3%(χ2=4.028, P=0.045), 27.3% and 0.0%(χ2=8.434, P=0.004), 27.3% and 0.0%(χ2=8.434, P=0.004), 63.6% and 27.6%(χ2=4.464, P=0.035), respectively. But there were no significant differences on neonatal outcomes in the two groups. Conclusions The re-pregnant women, who had history of cesarean section, with placenta previa and placenta implanted the front wall of uterus were at more risk of antepartum hemorrhage, postpartum hemorrhage, placenta adherence, placenta accrete, hysterectomy, disseminated intravascular coagulation, and premature birth. It is necessary to diagnose placenta position before delivery. Key words: Placenta previa; Previous cesarean section; Placenta position