Maternal Outcome of Placenta Previa in Scarred Uterus: A Comparative Study

MasumaTabassum1, Shahanara Chowdhury1 (1-Chittagong Medical College Hospital,(CMCH), Chattogram, Bangladesh

Correspondence: Dr. Masuma Tabassum, Consultant, MBBS(CMC),BCS (HEALTH),MS (BSMMU ,DHAKA),Department of Obstetrics and Gynaecology, Chittagong Medical College Hospital, Chattogram. Bangladesh. Email-masumaminhaz@gmail.com, cell:+8801717661892

BACKGROUND
Placental complications are closely associated with cesarean section(CS )like placenta previa (PP) and placenta accreta spectrum disorder (PAS).

RESEARCH HYPOTHESIS
Maternal outcome of placenta previa in scarred uterus is unfavorable than that of unscarred uterus.

OBJECTIVES
The study aimed to compare the maternal outcome of PP with H/O(CS) (scarred uterus) and PP without H/OCS (unscarred uterus).

RESULTS

Mean age of the women in scarred uterus group was 29.42±3.37 years. (p=0.001)
► About 72% of the patients with scarred uterus had grade IV placenta previa (p=<0.001).
► Significantly higher proportion of women with scarred uterus had PPH(p<0.001).
► 88% in unscarred uterus group were discharged from the hospital within 5th POD (p=0.003).
► There was statistically non-significant higher incidence of maternal death in patients with scarred uterus (6% vs2%,p=0.307)

CONCLUSION
► The present study is one of the few studies to compare maternal outcome of placenta previa in scarred (H/O CS) and unscarred uterus in Bangladesh.
► The study concludes that anterior placenta and morbidly adherent placenta are more common in patients with cesarean scar compared to patients without
cesarean scar.
► Placenta previa when combines with cesarean scarred uterus is more dangerous than placenta previa in unscarred uterus in view of increasing maternal morbidity such as increased blood transfusion, hysterectomy, bladder injury and PPH.

REF:

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