Maternal and perinatal outcome in placenta previa with scarred and unscarred uterus: a comparative study in a tertiary care centre and medical college

Abstract

Background: The incidence of placenta previa is increasing over the decades in view of increased incidence of caesarean delivery. Hence increasing the complications of scarred uterus during delivery. Aim: To compare maternal and perinatal outcome in placenta previa with scarred and unscarred uterus. Materials and methods: A case control study of 202 cases were divided into two groups - A (Scarred uterus involving 62 cases) and B (unscarred uterus involving 140 cases) for the study period of June 2017 to December 2019. Patients attending OPD/Labour room with complaints of antepartum haemorrhage or diagnosed placenta previa by ultrasonography after 24 weeks of gestation were included in the study. Results: Incidence of placenta previa in scarred uterus is 0.243% and unscarred uterus was 0.55%. Intraoperative complications like placental bed bleeding (p value - 0.000), atonic PPH (Post-Partum Haemorrhage) (p value-0.001), medical management of PPH (p value-0.001), pressure sutures (p value-0.306), accreta (0.000), bladder injury and repair (p value-0.000) were more in scarred uterus when compared to unscarred uterus. The birthweight, NICU (Neonatal Intensive Care Unit) admissions did not differ between scarred and unscarred uterus. Conclusions: In this study the intraoperative complications and postoperative morbidity was higher, which was statistically significant in scarred uterus group when compared to unscarred uterus group.

Keywords

• placenta accreta
• scarred uterus
• unscarred uterus