Keywords : placental position
Al- Anbar Medical Journal,
2016, Volume 13, Issue 1, Pages 125-135
Background: Placenta Previa is a leading cause of hemorrhage and is potentially fatal complication for the mother. In addition, pregnancies complicated by (Placenta previa) are at higher risk for adverse perinatal outcome: IUGR, prematurity and perinatal mortality. These finding may result from pathological implantation of the placenta that interfere with normal placental function and leads to abnormal fetal growth.
Aim of the study: To elucidate whether the location of placenta below uterine incision in caesarean section is important in development of fetomaternal complication in placenta previa patients.
Patients and methods: The study was conducted between 1st of March 2012 and 30th of May 2013 in the department of Obstetrics and Gynecology, Baghdad Teaching Hospital, Medical City Complex, Baghdad, Iraq. The study conducted on 100 patients starting at 32 weeks of gestation on ward being diagnosed as placenta previa by ultra sound scan; the subjects are divided into 2 groups: group (a) placenta is located in anterior wall of lower uterine segment. Group (b) placenta is located in posterior wall of lower uterine segment. The results of the 2 groups were compared to each other regarding fetomaternal complications.
Results: eighty five patients were found to have anterior placenta previa and 15 were posterior. Analysis of data show that antepartum hemorrhage, number of c/s, hysterectomy and placenta accreta, hospital staying (days) were significantly higher in anterior group with p value 0.017,0.006,0.027,0.032,0.008 respectively, while there was no statistically significant difference regarding maternal age, number of abortions, history of curettage, number of curettage, birth weight, apgar score1 and 5, neonatal care admission, blood transfusion, oversewing, visceral injury and maternal death.
Conclusions: anterior previa is more dangerous than posterior previa in view of increasing maternal and neonatal morbidity such as excessive blood loss, massive transfusion, placenta accreta and hysterectomy, as well as perinatal morbidity.