التفاصيل البيبلوغرافية
| العنوان: |
Major placenta previa among patients with and without previous cesarean section: Maternal characteristics, outcomes and risk factors. |
| المؤلفون: |
Shaamash, Ayman H.1 (AUTHOR) ashaamash@kku.edu.sa, AlQasem, Mehad H.1 (AUTHOR) malqasem@kku.edu.sa, Mahfouz, Ahmed A.2 (AUTHOR) mahfouz@kku.edu.sa, Al Ghamdi, Deama S.1 (AUTHOR) dalghamidi@kku.edu.sa, Eskandar, Mamdoh A.1 (AUTHOR) maeskandar@kku.edu.sa |
| المصدر: |
European Journal of Obstetrics & Gynecology & Reproductive Biology. May2024, Vol. 296, p280-285. 6p. |
| مصطلحات موضوعية: |
*CESAREAN section, *UTERINE rupture, *PLACENTA praevia, *PREGNANCY complications, *PLACENTA accreta, *VAGINAL birth after cesarean, *CHILDREN'S hospitals, *UTERINE surgery |
| مصطلحات جغرافية: |
SAUDI Arabia |
| مستخلص: |
• Generally, placenta previa (PP) and specifically major PP is a well-established risk factor during pregnancy, and is associated with the highest maternal and perinatal complication rates. • The presence of PP substantially increases the patient's risk for invasive placentation or placenta accreta spectrum (PAS). When pregnancies are complicated by both types of abnormal placentation (PP with PAS), a much higher risk of worse maternal outcomes is typically expected. • Moreover, evidence suggests that previous CS increases the risks of both PP and PAS, up to more than 67 % by 5th. repeated CS and PP will develop abnormal placentation (PAS). • This study aimed to find out the maternal outcomes of major PP (with or without PAS) among patients with history of "previous CS-one or more". To compare maternal characteristics and outcomes among patients having major placenta previa (PP) with and without previous cesarean section (CS). And to determine if previous CS alone is a risk factor for associated adverse maternal outcomes in these patients. This is a retrospective analysis including two groups of major PP patients, with previous CS (n = 184) and without CS (n = 115); who were admitted to Abha Maternity and Children's Hospital over the last ten-years (January 2012–December 2021), Aseer region, Saudi Arabia. Compared to those without previous CS, major PP patients with previous CS had significantly advanced ages with higher mean numbers of gravidity and parity, but significantly less rates of previous uterine surgery and IVF pregnancies. Moreover, they were more likely to acquire higher rates of adverse maternal outcomes. In the same way, these patients had an increased Odds Ratios of cesarean hysterectomy (OR of 20.462), urinary tract injuries (OR of 12.361), associated PAS (OR of 4.375), moderate/ heavy intra-operative bleeding (OR of 2.153) and the need for transfusion of 3+ units of packed RBCs (OR of 1.849). (1) Patients with combined existence of major PP and previous CS had significantly higher rates of adverse maternal outcomes (2) Alone, prior CS in major PP patients increased the Odds Ratios of cesarean hysterectomy, urinary tract injuries, diagnosis of PAS, excessive intra-operative bleeding and repeated packed RBCs transfusions. (3) Among our PP patients with previous CS, the increased rate and OR of PAS diagnosis could in-part explain the adverse maternal outcomes. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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