An observational study on abnormal placentation in women with 2 or more previous cesarean sections in a tertiary care centre

Abstract

Background: The incidence of placenta praevia is 1 in 200 pregnancies. Incidence increases with each successive caesarean delivery. Placenta previa is the main reason for postpartum hemorrhage. With abnormal placentation emergency hysterectomy might also be needed. Women in this area are at more risk due to various religious taboos that does not allow limitation of family size. Objectives: To assess abnormal placentation in women with 2 or more previous LSCS in a tertiary care centre and also to see the outcome in terms of occurrence of post partum haemorrhage and its management. Materials and methods: It is a prospective observational study conducted in our institute, during the period of January 2019 to December2019. A detailed proforma designed with cases fulfilling inclusion and exclusion criteria were enrolled and results obtained by applying proper statistical analysis. Results: Total 54 patients were enrolled out of which 50 were with previous 2 LSCS and 4 with previous 3 LSCS. 14.8% cases had placenta previa with 87.5% patients with placenta previa having adherent placenta. Women with previous 2 LSCS had 12% placenta previa whereas with previous 3 LSCS had 50%. Occurrence of placenta previa was statistically significant with increase in number of cesareans. Post partum haemorrhage occurred in 14.8% cases with 5.5% who underwent obstetric hysterectomy. Conclusion: The rate of placenta previa increases with increase in cesarean section rates. Early diagnosis, close monitoring and timely interventions play an important role in its management. Primary prevention will include justified cesarean section and promotion of normal deliveries to reduce its incidence with promotion of VBAC.

Keywords

• placenta previa
• adherent placenta
• cesarean sections
• hysterectomy