Effect of cesarean scar on placental location and postpartum hemorrhage
Abstract
Ø * Aim of the study:To determine if there is a relationship between previous cesarean scar and placental location .
To determine the relationship between the placental location and postpartum hemorrhage .
- Materials and methods:
This study was conducted on 328 pregnant women with previous cesarean section admitted to Tishreen University Hospital in Lattakia 2021-2022,who fulfilled the study conditions and criteria.
Ultrasound examinations were performed at gestational week 28-30 , and placental location was recorded .
Data on maternal age ,parity ,delivery mode , PPH , retained placenta were obtained for all women .
Outcome measures were PPH (more than 1,000 mL) and retained placenta .
* Results:
- The study showed :
- The overall incidence of PPH was 14.3% .
- The overall incidence of retained placenta was 2.7% .
- Twenty-one women (15.6%) with anterior placenta had PPH compared to 19 (11.9%) with posterior or fundal placenta . the adjusted OR was 1.3% , but the difference was not statistically significant .
- One woman (0.75%) with anterior placenta had retained placenta compared to 6 (3.77%) with posterior or fundal placenta . the adjusted OR was 0.19% , but the difference was not statistically significant .
- 100% of women with placenta previa had PPH , and 66.6% of women with placenta previa had retained placenta .
*Conclusion: women with previous cesarean section delivery had an increased risk for PPH and retained placenta .
The anterior placental location in women with previous cesarean section increased the risk for PPH without increasing the risk for retained placenta .
The placenta previa in women with previous cesarean section increased the risk for PPH and retained placenta .
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