scholarly journals Sonographic findings of placental lacunae and the prediction of adherent placenta in women with placenta previa totalis and prior Cesarean section

2006 ◽  
Vol 28 (2) ◽  
pp. 178-182 ◽  
Author(s):  
J. I. Yang ◽  
Y. K. Lim ◽  
H. S. Kim ◽  
K. H. Chang ◽  
J. P. Lee ◽  
...  
2020 ◽  
Author(s):  
Amer Sindiani ◽  
Nail Obeidat ◽  
Omar Abu-Azzam ◽  
Heba Hijazi

Abstract Background: to evaluate the impact of lower segment cesarean section (LSCS) on the maternal and fetal outcomes of women with non-adherent placenta previa (PP). Methods: This is a retrospective study of all women who delivered at our hospital by LSCS with non-adherent PP over a period of 10 years. Data were obtained through hospital registry and medical records search. Data were analyzed using the Statistical Package for Social Sciences (SPSS, version 20). The differences in demographic and obstetric characteristics, peripartum complications, and fetal outcomes between women with no previous CS and those with previous CS were analyzed using t test or chi-square test wherever appropriate. A p-value of less than 0.05 was considered statistically significant. Results A total of 90 women with non-adherent placenta were included, 54 women with no previous CS and 36 women with previous CS. Women with previous CS were significantly more likely to experience organ injury (p-value <0.005), transfusion of ≥ 4 units of PRBC (p-value = 0.034), transfusion of FFP (p-value = 0.034), and hysterectomy or other procedure ( B Lynch, Uterine artery ligation) use (p-value <0.005)Conclusion: There is a significant increase in the incidence of maternal morbidities such as hysterectomy, blood transfusion and organ injury in patients with non-adherent PP with previous CS, with no difference in perinatal outcome in the same group of patients.


2020 ◽  
Vol 15 (3) ◽  
pp. 314-318 ◽  
Author(s):  
Sung Mi Ji ◽  
Chaemin Cho ◽  
Gunhwa Choi ◽  
Jaegyok Song ◽  
Min A Kwon ◽  
...  

Background: Morbidly adherent placenta (MAP) may cause life-threatening postpartum hemorrhage (PPH) requiring massive transfusions. Furthermore, it could endanger the lives of both mother and baby. Despite various efforts, such as adjuvant endovascular embolization and hysterectomy, massive PPH due to MAP still occurs and is difficult to overcome. Case: Herein, we described the case of a 40-year-old woman with placenta previa totalis who experienced massive bleeding during a cesarean section. We used resuscitative endovascular balloon occlusion of the aorta (REBOA) and it improved the condition of the surgical field and the hemodynamic stability of the patient temporarily. The patient was successfully managed without further complications. Conclusions: REBOA can be used as a rescue procedure for uncontrolled bleeding situations in patients with MAPs. Anesthesiologists should consider and recommend REBOA as another resuscitative therapeutic option in the case of massive PPH.


2009 ◽  
Vol 62 (5-6) ◽  
pp. 212-216 ◽  
Author(s):  
Jelena Milosevic ◽  
Vekoslav Lilic ◽  
Marija Tasic ◽  
Dragana Radovic-Janosevic ◽  
Milan Stefanovic ◽  
...  

Introduction The incidence of cesarean section has been rising in the past 50 years. With the increased number of cesarean sections, the number of pregnancies with the previous cesarean section rises as well. The aim of this study was to establish the influence of the previous cesarean section on the development of placental complications: placenta previa, placental abruption and placenta accreta, as well as to determine the influence of the number of previous cesarean sections on the complication development. Material and methods The research was conducted at the Clinic of Gynecology and Obstetrics in Nis covering 10-year-period (from 1995. to 2005.) with 32358 deliveries, 1280 deliveries after a previous cesarean section, 131 cases of placenta previa and 118 cases of placental abruption. The experimental groups was presented by the cases of placenta previa or placental abruption with prior cesarean section in obstetrics history, opposite to the control group having the same conditions but without a cesarean section in medical history. RESULTS The incidence of placenta previa in the control group was 0.33%, opposite to the 1.86% incidence after one cesarean section (p<0.001), 5.49% after two cesarean sections and as high as 14.28% after three cesarean sections in obstetric history. Placental abruption was recorded as placental complication in 0.33% pregnancies in the control group, while its incidence was 1.02% after one cesarean section (p<0.001) and 2.02% in the group with two previous cesarean sections. The difference in the incidence of intrapartal hysterectomy between the group with prior cesarean section (0.86%) and without it (0.006%) shows a high statistical significance (p<0.001). CONCLUSION The previous cesarean section is an important risk factor for the development of placental complications.


2020 ◽  
Author(s):  
Ahmad B. Alwazzan ◽  
abdullah Kafy ◽  
Samera F. AlBasri ◽  
Ahmed A. Mousa ◽  
Lujain K. Halawani ◽  
...  

Abstract Background: To estimate the rate of placenta previa in relation to prior delivery via cesarean section (CS) during a 15-year period in an academic medical center, King Abdulaziz University Hospital (KAUH), in Jeddah, Saudi Arabia.Methods: In this retrospective study, we reviewed the medical records of all pregnant women who delivered at KAUH from January 2001 to December 2015. For each year, the research team recorded the total number of deliveries, as well as the number and percentage of CS deliveries and patients with placenta previa. The association between placenta previa and previous CS was assessed. Results: Out of the 62,701 deliveries at KAUH during the study period, 13,404 were CS deliveries, producing an overall CS rate of 21.4%. The total number of patients with placenta previa was 260, for a placenta previa rate of 4.14 cases/1,000 births. Of patients with placenta previa, 135 had a prior CS (60%), whereas 91 multigravida women had no previous CS (40%).There is positive correlation between number of CS and number of placenta pravia.Conclusion: In spite of, significant positive correlation between number of CS and number of placenta previa. The rate of placenta previa was not significantly different between patients with or without prior CS delivery. This suggests that factors other with previous CS could play role in the development of placenta previa especially in primgravida.


2004 ◽  
Vol 24 (3) ◽  
pp. 220-220
Author(s):  
J. I. Yang ◽  
Y. K. Lim ◽  
S. J. Chang ◽  
H. S. Kim ◽  
M. R. Kim ◽  
...  

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Midori Fujisaki ◽  
Seishi Furukawa ◽  
Yohei Maki ◽  
Masanao Oohashi ◽  
Koutarou Doi ◽  
...  

Objective. To determine maternal morbidity in women with placenta previa managed with prediction of morbidly adherent placenta (MAP) by ultrasonography. Methods. A retrospective cohort study was undertaken comprising forty-one women who had placenta previa with or without risk factors for MAP. Women who had all three findings (bladder line interruption, placental lacunae, and absence of the retroplacental clear zone) were regarded as high suspicion for MAP and underwent cesarean section followed by hysterectomy. We attempted placental removal for women having two findings or less. Results. Among 28 women with risk, nine with high suspicion underwent hysterectomy and were diagnosed with MAP. Three of 19 women with two findings or less eventually underwent hysterectomy and were diagnosed with MAP. The sensitivity and positive predictive value for the detection of MAP were 64% and 100%. The pathological severity of MAP was significantly correlated with the cumulative number of findings. There were no cases of MAP among 13 women without risk. There was no difference of blood loss between women with high suspicion and those without risk (2186±1438 ml versus 1656±848 ml, resp.; p=0.34). Conclusion. Management with prediction of MAP by ultrasonography is useful for obtaining permissible morbidity.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Amer Sindiani ◽  
Nail Obeidat ◽  
Omar Abu-Azzam ◽  
Heba Hijazi

Abstract Objective To evaluate the impact of previous lower segment cesarean section on maternal and fetal outcomes of patients with non-adherent placenta previa Methods This 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. Results Ninety 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. Conclusion There 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.


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