PLACENTA PRAEVIA AND MATERNAL MORBIDITY IN SCARRED UTERUS
DOI:
https://doi.org/10.48047/Keywords:
Scarred uterus, maternal morbidity, placenta PraeviaAbstract
OBJECTIVES: To determine the frequency and types of placenta praevia (PP) in previous one caesarean section (C/S) along with associated maternal morbidity and mortality in resource poor country like Pakistan where social preference is for large family size.
METHOD: Prospective case series was conducted in department of obstetrics and gynecology civil hospital Karachi from March 8th 2018 to march 8th 2019. All pregnant women with singleton pregnancy and previous one cesarean section were included. Gestational age and type of praevia was confirmed by prenatal ultrasound and clinical examination. Maternal outcomes were assessed in terms of complications like post-partum hemorrhage (PPH), Obstetrical hysterectomy, need for blood transfusion and intensive care unit admission. RESULTS:One hundred and thirty nine pregnant women were included in this study. Mean age of women was 30.9 ±1.6 years. Mean gestational age was 38.2 ±1.6 Weeks. PP was found in 8 (5.8%) women. Type 2 was seen in 4 (50%) of women. Out of 8 women with PP, maternal morbidity was seen in 5 (62.5%) cases. Blood transfusion was given in 4 (50%) women. Obstetrical hysterectomy was observed in only 1 (12.5%) woman and only one patient shifted to intensive care unit (12.5%) because of massive PPH. Type-IV PP was most frequently associated with maternal morbidity (50%).Conclusion: A previous one C/S is associated with increased risk of PP especially type-II PP, although type-IV was most commonly associated with maternal morbidity.
Downloads
References
James D, Bleeding in pregnancy. In Johnson M, chang A, Nelson Jeditor. Turnbull obstetrics 3rd ed. Edinburgh: Harcourt publishers LTD 2001:211- 28.
Kavita B, Hota B M. Clinic study of placenta praevia in scarred and unscarred uterus. JNTR Univ Health Sci 2018;7:13-18.
Kausar S, Zahoor B, Ali R Kausar S, Zahoor B, Ali R. Morbidity with Placenta Previa . A.P.M.C 2012;6:186-89.
Nasreen F. Incidence, causes and outcome of placenta previa. J Post grad Med Inst 2003; 17:99-104.
Yu FNY, Leung KY. Antenatal diagnosis of placenta accreta spectrum (PAS) disorders. Best practice Res Clin Obstet Gynaecol 2021 Apr;72:13-24.
Perveen S, Hasnain AZ. Scarred uterus; frequency of placenta praevia .
Professional Med J 2012;19:1-4.
Konje JC, Taylor DJ. Bleeding in Late Pregnancy. In James D K, Weiner C P, Steer P J, Gonik B. High risk pregnancy management options. 3rd edition Philadelphia: Saunders, 2006:1261-66.
Kouser S, Sateen A, Younas S, Begum A. Placenta previa and correlation with scarred uterus. Ann King Edward Med Coll 2006; 12:458-60.
Haider G, Zehra N,Munir AA, A frequency and indications of caesarean section in tertiary care hospital.Pak .J ,Med.Sci 2009; 5: 791-96.
Naz S, Parveen R, Bhatti A. Major placenta praevia –a true obstetric emergency. Medical channel 2009;15:74-77.
Ananth CV, Smulian JC, Vintzileos AM. The effect of placenta previa on neonatal mortality: a population-based study in the United States, 1989 through 1997. Am J Obstet Gynecol 2003;188:1299–304.
Javaid S. Yasmeen T. Placenta Praevia and Accreta and its Relationship with Previous Caesarean Section. Pak J Med Sci 2011;5:1-5.
Shaukat A, Zafar F, Asghar S, Nighat, Ayoob A, Ambreen N et al .
Frequency of placenta praevia with previous C section. Pak J Med Sci 2007;5,42-8.
Metgut M, koli P, Nilgar B, Mallapur M. Association of first birth cesarean delivery and placental abruption or previa at second birth. Int scien j jaypee 2010;2:23-26.
Hendricks M, chow Y H. Previous caesarean section and abortion as risk factor for developing placenta praevia. J Obstet Gynaecol 1999;25:137- 42.
Reviewed by the baby centre medical advisory board last updated; May 2006.
Reproductive Health Study, National Health Survey. Proportion of women currently pregnant. Volume 2. Oman: Ministry of Health; 2000.
Rasmussen S, Albrechsten S. Dalaker K. Obstetrics history and risk of Placenta Praevia. Act obstet Gynaecol Scand 1997;177:1-16.
Gilliam M, Rosenberg D, Davis F. The likelihood of placenta previa with greater number of cesarean deliveries and higher parity. Obstet Gynecol 2002;99:976-80.
Hossain GA, Islam SM, Mahmood S, Chakraborty RK, Akhter N, Sultana S. Placenta previa and it's relation with maternal age, gravidity and cesarean section. Mymensingh Med J. 2004 Jul;13(2):143-8.
McShane PM, Heyl PS, Epstein MF. Maternal and Perinatal Morbidity Resulting From Placenta Previa. Obstet Gynaecol 1985;65:176-82.
Parijchatt A and Tongswatwong P. Risk Factors Associated with Placenta Previa at Maharat Nakorn Ratchasima Hospital. Thai J Obstet Gynaecol 2009;17:212-8.
Majeed T, Waheed F, Mahmood Z, Saba K, Mahmood H. Frequency of placenta praevia in previously scarred and non scarred uterus. Pak j Med Sci 2015Mar-Apr;31:360
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Author
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
