scholarly journals Risk Factors and Pregnancy Outcome in Women With a History of Cesarean Section Complicated by Placenta Accreta

2020 ◽  
Author(s):  
Yingyu Liang ◽  
lizi Zhang ◽  
Shilei Bi ◽  
Jingsi Chen ◽  
Shanshan Zeng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Cesarean Sections ◽  
Han Ethnicity ◽  
Parity Number ◽  
History Of ◽  
Independent Risk Factors ◽  
Previous Cesarean

Abstract Objective: To explore the risk factors and pregnancy outcomes in women with a history of cesarean section complicated by placenta accreta.Methods: This retrospective study included clinical data from singleton mothers with a history of cesarean section in 11 public tertiary hospitals in 7 provinces of China between January 2017 and December 2017. According to the intraoperative findings or the pathologic diagnosis after delivery, the study population was divided into placenta accreta (PA) and non-PA groups. We compared the pregnancy outcomes between the 2 groups, used multivariate logistic regression to analyze the risk factors for placental accreta, and used receiver operating characteristic curves to evaluate the value of the risk factors.Results: For this study we included 11,074 pregnant women with a history of cesarean section; and of these, 869 cases were in the PA group and 10,205 cases were in the non-PA group. Compared with the non-PA group, the probability of postpartum hemorrhage, severe postpartum hemorrhage, diffuse intravascular coagulation, puerperal infection, intraoperative bladder injury, hysterectomy, and blood transfusion was significantly increased in the placenta accreta group (P<0.05)). At the same time, the rate of neonatal low-birth weight, the probability of neonatal comorbidities, and the rate of neonatal intensive care unit admission also increased significantly (P<0.05). Weight, parity, number of miscarriages, number of previous cesarean sections, history of premature rupture of membrane, previous cesarean-section transverse incisions, history of placenta previa, and the combination of prenatal hemorrhage and placenta previa were all independent risk factors for placenta accreta; while non-Han ethnicity was an independent protective factor for placenta accreta (P<0.05). The area under the ROC curve (AUC) was 0.93 (95% CI=0.92-0.94); and the specificity, sensitivity, and accuracy rate were 0.87, 0.93, and 0.93, respectively.Conclusions: There was an increased risk of adverse outcomes in pregnancies complicated by placenta accreta in women with a history of cesarean section, and this required close clinical attention. Weight before pregnancy, parity, number of miscarriages, number of previous cesarean sections, Han ethnicity, history of premature rupture of membranes, past transverse incisions in cesarean sections, a history of placenta previa, prenatal hemorrhage, and placenta previa were independent risk factors for pregnancies complicated with placenta accreta in women with a history of cesarean section. These independent risk factors showed a high value in predicting the risk for placental accreta in pregnancies of women with a history of cesarean section.

scholarly journals A Planned Cesarean Section-Hysterectomy For Placenta Previa Totalis Percreta In Patient With History Of Two Cesarean Sections

Medicinus ◽  
2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Julita Nainggolan
Keyword(s):  
Cesarean Section ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Health Resources ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Cesarean Sections ◽  
History Of ◽  
Rising Incidence ◽  
Previous Cesarean

<p><em>The presence of placenta previa may be associated with placenta accreta</em><em><sup>[1]</sup></em><em>.<sup>  </sup></em><em>Maternal and fetal morbidity and mortality from placenta previa accreta are considerable and are associated with high demands on health resources. With the rising incidence of caesarean sections combined with increasing maternal age, the number of cases of placenta praevia and its complications, including placenta accreta, will continue to increase</em><em><sup>[2]</sup></em><em>. </em><em>Here, we present a case of  placenta previa totalis percreta in previous cesarean section twice. In this case, patient with placenta previa totalis-percreta we diagnosed and prepared  proper management with the involvement of multidisciplinary team. We reduced blood loss by performing total abdominal hysterectomy immediately after delivered the baby and the postoperative course was uneventful.</em></p><p><strong><em>Keywords: Cesarean Section-Hysterectomy, placenta accreta, placenta percreta, placenta previa</em></strong></p>

scholarly journals A Planned Cesarean Section-Hysterectomy for Placenta Previa Totalis Percreta in Patient with History of Two Cesarean Sections

Medicinus ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 13
Author(s):  
Julita Nainggolan
Keyword(s):  
Cesarean Section ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Health Resources ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Cesarean Sections ◽  
History Of ◽  
Rising Incidence ◽  
Previous Cesarean

<p class="Default">The presence of placenta previa may be associated with placenta accreta<sup>[1]</sup>.<sup>  </sup>Maternal and fetal morbidity and mortality from placenta previa accreta are considerable and are associated with high demands on health resources. With the rising incidence of caesarean sections combined with increasing maternal age, the number of cases of placenta praevia and its complications, including placenta accreta, will continue to increase<sup>[2]</sup>. Here, we present a case of  placenta previa totalis percreta in previous cesarean section twice. In this case, patient with placenta previa totalis-percreta we diagnosed and prepared  proper management with the involvement of multidisciplinary team. We reduced blood loss by performing total abdominal hysterectomy immediately after delivered the baby and the postoperative course was uneventful.<strong></strong></p>

scholarly journals Placenta praevia: percreta and accreta, our experience

2020 ◽  
Vol 9 (3) ◽  
pp. 928
Author(s):  
Preeti F. Lewis ◽  
Shreya Chinchoriya
Keyword(s):  
Risk Factors ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
History Of ◽  
Previous Cesarean

Background: morbidly adherent placenta has an increasing incidence over decades. The purpose of this study is to identify risk factors and etiology of placenta previa- accreta and percreta.Methods: A cross sectional observational study of patients with morbidly adherent placenta previa including placenta accreta and placenta percreta were studied over a period of three years from June 2017 to June 2019 in a tertiary care centre, Mumbai.Results: Cases showed a higher incidence in patients with previous cesarean delivery (CS), grandmultiparity, abortions without the history of check curettage and anterior/central placentae.Conclusions: History of uterine surgeries and previous cesarean are some important risk factors for accreta in placenta previa patients.

scholarly journals Outcome of Pregnancy with History of Previous Cesarean Section

2017 ◽  
Vol 9 (4) ◽  
pp. 308-311
Author(s):  
Reena J DSouza ◽  
Bandeppa H Narayani ◽  
Smitha B Rao
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Perinatal Death ◽  
Placenta Previa ◽  
Birth Asphyxia ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
History Of ◽  
Previous Cesarean

ABSTRACT In modern obstetric practice, pregnancy with history of previous cesarean section is quite common. A cesarean section poses some documented risks to the mother's health in subsequent pregnancies like placenta previa or accreta and uterine scar rupture. It is also associated with increased likelihood of preterm delivery, low birth weight, and perinatal death. Repeat cesarean section is technically difficult and there is chance of injury to surrounding structures. The retrospective study was done in Yenepoya Medical College Hospital during the period of January 2014 to January 2015 to find out the maternal antepartum and intrapartum complications as well as perinatal outcome in patients with a history of cesarean section. A total number of 143 pregnant patients with history of one or more cesarean section who underwent repeat cesarean sections were included. Previous classical cesarean, extreme prematurity, and those who opted for vaginal birth after cesarean (VBAC) were excluded. Mean age of the study population was 27.4 years. Here, 72.12 and 20.98% cases had history of previous one and two cesarean sections respectively. Important antepartum complications were placenta previa (3.50%), scar tenderness (8.39%), gestational diabetes mellitus (GDM; 4.90%), pregnancy-induced hypertension (PIH; 6.99%), etc. There were extensive peritoneal and bladder adhesions in 13.99 and 16.78% cases respectively, causing much preoperative difficulties and in one case urinary bladder was injured during operation. Postoperative period was uneventful in 72.72% cases. In this study, 20.28% neonates developed some complications like prematurity, low birth weight, birth asphyxia, and neonatal jaundice. Here the rate of perinatal mortality was 1.4%. How to cite this article DSouza RJ, Narayani BH, Rao SB. Outcome of Pregnancy with History of Previous Cesarean Section. J South Asian Feder Obst Gynae 2017;9(4):308-311.

scholarly journals Prevalence and risk factors of severe postpartum hemorrhage: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chen-ning Liu ◽  
Fu-bing Yu ◽  
Yun-zhe Xu ◽  
Jin-sheng Li ◽  
Zhi-hong Guan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Maternal Age ◽  
Placenta Previa ◽  
Previous Cesarean Section ◽  
Estimated Blood Loss ◽  
History Of ◽  
Prolonged Labor ◽  
Previous Cesarean

Abstract Background Although maternal deaths are rare in developed regions, the morbidity associated with severe postpartum hemorrhage (SPPH) remains a major problem. To determine the prevalence and risk factors of SPPH, we analyzed data of women who gave birth in Guangzhou Medical Centre for Critical Pregnant Women, which received a large quantity of critically ill obstetric patients who were transferred from other hospitals in Southern China. Methods In this study, we conducted a retrospective case-control study to determine the prevalence and risk factors for SPPH among a cohort of women who gave birth after 28 weeks of gestation between January 2015 and August 2019. SPPH was defined as an estimated blood loss ≥1000 mL and total blood transfusion≥4 units. Logistic regression analysis was used to identify independent risk factors for SPPH. Results SPPH was observed in 532 mothers (1.56%) among the total population of 34,178 mothers. Placenta-related problems (55.83%) were the major identified causes of SPPH, while uterine atony without associated retention of placental tissues accounted for 38.91%. The risk factors for SPPH were maternal age < 18 years (adjusted OR [aOR] = 11.52, 95% CI: 1.51–87.62), previous cesarean section (aOR = 2.57, 95% CI: 1.90–3.47), history of postpartum hemorrhage (aOR = 4.94, 95% CI: 2.63–9.29), conception through in vitro fertilization (aOR = 1.78, 95% CI: 1.31–2.43), pre-delivery anemia (aOR = 2.37, 95% CI: 1.88–3.00), stillbirth (aOR = 2.61, 95% CI: 1.02–6.69), prolonged labor (aOR = 5.24, 95% CI: 3.10–8.86), placenta previa (aOR = 9.75, 95% CI: 7.45–12.75), placenta abruption (aOR = 3.85, 95% CI: 1.91–7.76), placenta accrete spectrum (aOR = 8.00, 95% CI: 6.20–10.33), and macrosomia (aOR = 2.30, 95% CI: 1.38–3.83). Conclusion Maternal age < 18 years, previous cesarean section, history of PPH, conception through IVF, pre-delivery anemia, stillbirth, prolonged labor, placenta previa, placental abruption, PAS, and macrosomia were risk factors for SPPH. Extra vigilance during the antenatal and peripartum periods is needed to identify women who have risk factors and enable early intervention to prevent SPPH.

scholarly journals Pregnancy complicated by previous cesarean section: a retrospective study

2018 ◽  
Vol 7 (11) ◽  
pp. 4470
Author(s):  
Poornima M.
Keyword(s):  
Retrospective Study ◽  
Cesarean Section ◽  
Medical Records ◽  
Neonatal Outcome ◽  
Perinatal Morbidity ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Exclusion Criteria ◽  
History Of ◽  
Previous Cesarean

Background: Previous Cesarean section (CS) is one of the important causes of CS in subsequent pregnancies. Moreover, repeated cesarean sections increase maternal as well as perinatal morbidity and mortality. We conducted this study to find out outcome of pregnancies in women who had a history of previous CS.Methods: This was a retrospective study of patients of previous caesarean section for either maternal or fetal indications. The duration of study was 3 years. Total 215 patients were included in this study on the basis of a predefined inclusion and exclusion criteria. The indications, maternal and neonatal outcome were studied from medical records of the patients. Statistical analysis was done using SSPE 22.0 software.Results: Out of 215 studied cases majority of the patients belonged to age group of 21-30 years (75.35%) and were 2nd gravida (61.86%). 164 (76.28%) patients attended ANC OPD at least for 3 times during pregnancy. 73 (33.95%) patients had Hb of less than 10 gms while blood transfusion was required to be given in 11 (5.12%) patients. cesarean section was required in 172 (80%) patients out of which 166 (77.21%) patients had undergone emergency LSCS while in 6 (2.79%) patients elective LSCS was done. Scar tenderness was the most common indication for repeat cesarean section. There was no maternal mortality in any patients while there was 1 still birth and 1 neonatal death.Conclusions: Previous cesarean section is one of the important causes of CS in subsequent pregnancies hence decision of doing CS, especially primigravida, must be taken in accordance with strict guidelines and the practice of “cesarean section on demand” should be discouraged.

scholarly journals Torsion of term gravid uterus with a large leiomyoma

2016 ◽  
Vol 6 (1) ◽  
pp. 284
Author(s):  
Berna Aslan Çetin ◽  
Pınar Yalçın Bahat ◽  
Selin Dikmen ◽  
Erkan Şimşek ◽  
Alev Aydın
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Gravid Uterus ◽  
Cesarean Sections ◽  
Previous Cesarean

Torsion of gravid uterus is a rare obstetric event and it is almost always diagnosed during cesarean section. Leiomyomas and previous cesarean sections are predisposing risk factors. We report a case of 180 degree torsion of a term gravid uterus with only symptom of hematuria.

scholarly journals PLACENTA ACCRETA IN PLACENTA PREVIA

2018 ◽  
Vol 21 (05) ◽  
pp. 892-896
Author(s):  
Farzana Majid ◽  
Robina Ali ◽  
Shazia Shaheen
Keyword(s):  
Placenta Accreta ◽  
Placenta Previa ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
History Of ◽  
Scarred Uterus ◽  
Demographic Features ◽  
Previous Cesarean

Objective: To calculate the frequency of placenta accreta in placenta previawith or without scarred uterus and compare clinico demographic features of cases with orwithout placenta accreta. Study Design: Cross sectional study. Place and Duration of Study:Department of Obst & Gynae Allied Hospital, Faisalabad from 1st June 2007 to 31st May 2008.Methodology: 200 patients of placenta previa, 100 with history of previous cesarean sectionand 100 without history of previous C-section fulfilling inclusion criteria were taken. They wereevaluated by history, examination and ultrasound noting placental location and type. Placentaaccreta was diagnosed during delivery. Results: Out of 200 patients, frequency of placentaaccreta was significantly increased with history of previous C-section. It was 20% in patientswith previous C-sections and 6% in patients without previous C-sections. Conclusions: Ourdata suggests that frequency of placenta accreta is greater in patients with previous C-sectionand its frequency increases with increasing number of C-sections especially with anterior andcentral placenta previa.

scholarly journals Incidence and Risk Factors of Postpartum Hemorrhage in China: A Multicenter Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Sijian Li ◽  
Jinsong Gao ◽  
Juntao Liu ◽  
Jing Hu ◽  
Xiaoxu Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Cesarean Section ◽  
Subgroup Analysis ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Mode Of Delivery ◽  
Predictive Performance ◽  
Vaginal Deliveries ◽  
Twin Pregnancies

Background: Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality worldwide but the incidence and its risk factors in China is limited. The objective of this study is to investigate the incidence and the risk factors of PPH in Chinese women.Methods: A multi-center retrospective study of pregnant women at ≥28 weeks of gestation was conducted. Logistic regression was used to identify potential risk factors of PPH and receiver operating characteristic curve was used to evaluate the predictive performance of the identified risk factors. Subgroup analysis focusing on the number of fetus and the mode of delivery was conducted.Results: A total of 99,253 pregnant women were enrolled and 804 (0.81%) experienced PPH. The subgroup analysis revealed that the incidence of PPH was 0.75, 2.65, 1.40, and 0.31% in singletons, twin pregnancies, cesarean sections, and vaginal deliveries, respectively. Placenta previa and placenta accreta were the predominant risk factors of PPH in the overall population and all subgroups. A twin pregnancy was a risk factor for PPH regardless of the mode of delivery. Obesity, and multiparity were risk factors for PPH in both singletons and cesarean section cases, but the latter predicted a reduced probability of PPH in vaginal deliveries. Macrosomia was associated with increased risk of PPH in singletons or vaginal deliveries. In women who delivered vaginally, preeclampsia was associated with a higher risk of PPH. The areas under the curve for the overall cohort, singletons, twin pregnancies, cesarean section cases, and vaginal deliveries were 0.832 (95% confidence interval [CI] 0.813–0.851), 0.824 (95% CI 0.803–0.845), 0.686 (95% CI 0.617–0.755), 0.854 (95% CI 0.834–0.874), and 0.690 (95% CI 0.646–0.735), respectively.Conclusions: The risk factors of PPH varied slightly based on the number of fetuses and the mode of delivery, while placenta previa and placenta accreta were the two major risk factors. A combination of the identified risk factors yielded a satisfactory predictive performance in determining PPH in the overall cohort, singletons pregnancies, and women who delivered by cesarean section, whereas the performance was moderate in twin pregnancies and in women delivering vaginally.

Risk Analysis of Placenta Previa in Subsequent Pregnancy with History of Cesarean Section: A Case Control Study in Faridpur Medical College Hospital

2016 ◽  
Vol 10 (2) ◽  
pp. 52-54
Author(s):  
Dilruba Zeba ◽  
Shila Rani Das ◽  
Swapan Kumar Biswas ◽  
Rajib Kumar Roy ◽  
Abul Fattah ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Placenta Previa ◽  
Subsequent Pregnancy ◽  
Medical College Hospital ◽  
Bladder Injury ◽  
College Hospital ◽  
Medical College ◽  
History Of ◽  
Previous Cesarean

Placenta previa is a life threatening pregnancy complication where placenta partially or completely covers the internal cervical os causing serious adverse consequence for both mother and baby. History of cesarean delivery is an important risk factor for placenta previa. Which have a increased chance of cesarean hysterectomy and bladder injury because of an associated accrete syndrome. The objective of this study is to analyze the outcome of placenta previa with history of cesarean section. This is a prospective study done in Faridpur Medical College Hospital, Bangladesh from 01.01.2013 up to 31.12.14. Total 18 (study group) patients had undergone cesarean delivery with placenta previa and history of previous cesarean section. Among 18 patients maternal age range was 25- 40, parity 1-4, emergency hysterectomy was done in 11, average blood transfusion 2-8 and other morbidity like urinary bladder injury was 4. So we decided to conduct the study to evaluate the frequency of the placenta previa and morbidity related to number of previous cesarean deliveries.Faridpur Med. Coll. J. Jul 2015;10(2): 52-54

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