Risk of adverse maternal and peri-natal outcome in subjects with placenta previa with previous cesarean section

Abstract

The aim of this study was to compare maternal and perinatal adverse outcomes between groups of placenta previa (PP) with and without previous cesarean section (CS). A prospective study was carried out from March 2008 to August 2009 at the department of Obstetrics and Gynecology, Hera General Hospital, Makkah, Saudi Arabia. Diagnosed cases of PP with singleton pregnancy presenting with ante-partum hemorrhage (APH) in the 3rd trimester undergoing either emergency or elective CS were included. Subjects were divided into two groups, 30 with previous CS (group A) and 27 without previous CS (group B), and the risks of adverse maternal and perinatal outcomes were compared. Data were analyzed using SPSS version 16 (SPSS Inc., Chicago, IL, USA). One mother in group A died due to disseminated intravascular coagulation. The risk of post partum hemorrhage (PPH), blood transfusion and coagulopathy was higher in group A, (OR 4.8, 95% CI 1.5-15; p=0.008; OR 4.8, 95% CI 1.5-15; p=0.008; OR 9.5, 95% CI 1.2-81.6; p=0.03, respectively). Mean length of hospital stay (days±SD) in group A was significantly longer than that in group B (5.3±3.2 vs. 3.2±1.5, 95% CI 0.8-3.2; p=0.002). A higher risk of perinatal adverse outcome was found in group A, but the difference was not significant. Risk of maternal morbidity was higher than that of perinatal morbidity in Group A.