Placenta Previa Accreta and Previous Cesarean Section

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.

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Outcome of Pregnancy with History of Previous Cesarean Section

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1519 ◽

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.

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Letter to the Editor on the article “Clinical evaluation of balloon occlusion of the lower abdominal aorta in patients with placenta previa and previous cesarean section: A retrospective study on 43 cases.”: The drier the surgical field, the better?

International Journal of Surgery ◽

10.1016/j.ijsu.2016.10.047 ◽

2017 ◽

Vol 39 ◽

pp. 148-149 ◽

Cited By ~ 3

Author(s):

Shigeki Matsubara ◽

Hironori Takahashi ◽

Yosuke Baba ◽

Hiroyasu Nakamura

Keyword(s):

Retrospective Study ◽

Cesarean Section ◽

Clinical Evaluation ◽

Abdominal Aorta ◽

Placenta Previa ◽

Balloon Occlusion ◽

Previous Cesarean Section ◽

Letter To The Editor ◽

Surgical Field ◽

Previous Cesarean

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Reply to “Placenta Previa Accreta and Previous Cesarean Section

Chinese Medical Journal ◽

10.4103/0366-6999.233962 ◽

2018 ◽

Vol 131 (12) ◽

pp. 1505

Author(s):

Xiao-Ming Shi ◽

Yan Wang ◽

Yan Zhang ◽

Yuan Wei ◽

Lian Chen ◽

...

Keyword(s):

Cesarean Section ◽

Placenta Previa ◽

Previous Cesarean Section ◽

Previous Cesarean

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P49.04: A clinical review of placenta previa and placanta accreta in previous Cesarean section

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.5035 ◽

2007 ◽

Vol 30 (4) ◽

pp. 640-641

Author(s):

A. Iwata ◽

K. Baba ◽

M. Ebine ◽

Y. Murayama ◽

Y. Takai ◽

...

Keyword(s):

Cesarean Section ◽

Clinical Review ◽

Placenta Previa ◽

Previous Cesarean Section ◽

Previous Cesarean

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

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03818-1 ◽

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.

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