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Safia Ewaz Ali, Zubia Bugti and Rizwana Naz

ABSTRACT

Objective: To determine the frequency of abnormal placentation in patients with previous caesarean section.

Study Design: Descriptive study.

Place and Duration of Study: This study was conducted at the Department of Obstetrics and Gynecology, Civil Hospital Quetta for a period of one year, from 1^st June 2020, to 30^th June 2021.

Materials and Methods: A total of 156 patients were evaluated and studied. All cases of placenta previa with previous caesarean scar after 32 weeks of gestation whether booked or unbooked with no demarcation of age, irrespective to number of caesarean scars with or without bleeding per vagina were included in the study. All cases of previous myomectomy, uterine repair, placental abruption and bleeding per vagina due to local cause were excluded. A questionnaire was developed that included detailed information regarding maternal age, parity, gestational age, number of previous caesarean deliveries, history of bleeding per vagina, ultrasound findings and Doppler flow studies. Patients fulfilling the inclusion criteria were selected. Patients were divided into four groups according to number of previous caesarean sections and labeled as; Group A previous one caesarean section, Group B previous two caesarean sections, Group C previous three caesarean sections and Group D previous four caesarean sections. All the data were collected on pre-designed pro-forma. The data was entered and analyzed in SPSS version 18. Descriptive statistics were used to analysis the mentioned continuous variables. Chi-square independent test were used to determine the proportions difference between number of previous C-section and abnormal adherence placenta.  A p- value of ≤ 0.05 were considered as significant.

Results: The average age of the women was 27.02±5.13 year’s patients ranged between 18-35 years of age. Median age was 27 years. Mean gestational age was 35.79±2.07 ranging between 33-39 weeks. Similarly, number of previous cesarean section was 2.53±1.12 and the parity was found 4.66±2.28 respectively. 74(47%) women had already booked the status for cesarean section. Presentation of pregnant cases with previous C-section, 81(52%) women had symptomatic and 71(45.5%) had asymptomatic presentation. Age distribution of the patients was done; where in 85 patients accounted for 57.1% were age found more than 26 years. Gestational age of the patients revealed 99(63.5%) between 33-36 weeks, 57(36.5%) between 33-36 weeks, and 80 between 37-39 weeks. Degree of placenta Previa revealed 115 (74%) with major degree Previa and 41(26%) with minor degree Previa. The frequency of abnormal placenta Previa was found in Placenta accrete was 8(5.1%), placenta Percreta was 17(10.9%) while it was 28(17.9%) in placenta increta respectively. The percentage of placenta previa showed a rising value with increased number of caesarean scars as it was 23.7% in previous one caesarean section, 26.3% in previous two and 23.7% and 26.3% in previous three and four caesarean sections.

Conclusion: During the one-year study, 156 patients presented with placenta Previa. The study showed that the incidence of the condition increased with increased number of caesarean sections.

Key Words: Abnormal Placentation, Patients, Caesarean Section

Citation of article: Ali SE, Bugti Z, Naz R. Abnormal Placentation in Patients with Previous Caesarean Section. Med Forum 2022;33(4):59-62.