Abstract
ObjectiveTo evaluate the impact of previous lower segment cesarean section on maternal and fetal outcomes of patients with non-adherent placenta previaMethodsThis is a retrospective study of all patients who delivered at a tertiary referral university hospital by lower uterine cesarean section with non-adherent placenta previa, over a 10-year period. Data were obtained through hospital registry and medical records. The differences in demographic, obstetric characteristics, peripartum complications, and fetal outcome between patients with no previous cesarean and those with previous cesarean section were analyzed.ResultsNinety patients with non-adherent placenta previa were included, 54 patients with no previous cesarean and 36 patients with previous cesarean section. Patients with previous cesarean section were significantly more likely to incur inadvertent organ injury, transfusion of 4 or more units of packed red blood cells, transfusion of fresh frozen plasma, uterine brace compressive sutures, uterine artery ligation, and peripartum hysterectomy.ConclusionThere is a significant increase in the incidence of inadvertent neighboring viscus injury, transfusion of 4 units or more of packed red blood cells, transfusion of fresh frozen plasma, uterine brace compressive sutures, uterine artery ligation, and peripartum hysterectomy in patients with non-adherent placenta previa and previous cesarean section, compared to those with non-adherent placenta previa and no previous history of cesarean section, with no difference in perinatal outcome.
Highlights
The etiology of placenta previa (PP) remains unclear, many studies show that the incidence of PP has been rising in parallel with the increasing rate of cesarean delivery [1,2,3,4,5,6,7]
This risk is more pronounced in the case of morbidly adherent placenta previa (MAPP) accreta, increta, and percreta
While the maternal risk related to morbidly adherent placenta previa is well established [14,15,16], few studies have explored the outcome of non-adherent placenta previa in patients with previous one or more lower uterine segment cesarean section (LUSCS)
Summary
The etiology of placenta previa (PP) remains unclear, many studies show that the incidence of PP has been rising in parallel with the increasing rate of cesarean delivery [1,2,3,4,5,6,7]. The rate of primary and overall cesarean sections (CS) has been steadily and significantly rising. This increase has been attributed to multiple factors including increased maternal requests and obstetricians’ preference [8, 9]. Placenta previa is associated with the increased risk of maternal and perinatal morbidity and mortality [13, 14]. This risk is more pronounced in the case of morbidly adherent placenta previa (MAPP) accreta, increta, and percreta. While the maternal risk related to morbidly adherent placenta previa is well established [14,15,16], few studies have explored the outcome of non-adherent placenta previa in patients with previous one or more lower uterine segment cesarean section (LUSCS)
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