A study on correlation of placenta praevia with previous caesarean section and other risk factors

Authors

  • Somika Kaul Department of Obstetrics and Gynaecology, Medical College Vadodara, Gujarat, India
  • Shahida Mir Department of Obstetrics and Gynaecology, Lalla Ded Hospital, Government Medical College Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20192477

Keywords:

Abortion, Antepartum haemorrhage, Caesarean section, Dilatation and curettage, Placenta praevia

Abstract

Background: Obstetric haemorrhage is the leading cause of preventable maternal mortality worldwide. One of the major contributors to obstetric haemorrhage is antepartum haemorrhage which is mainly caused by placenta praevia and abruptio placenta. The study aims to quantify the risk of placenta praevia based on the presence and number of caesarean sections and to assess other risk factors.

Methods: This study was a prospective case control study conducted in the department of obstetrics and gynecology, Lalla Ded hospital, Srinagar, Jammu and Kashmir, India from August 2009 to October 2010. As per the inclusion and exclusion criteria of study 100 cases and 200 controls were selected and the association of placenta praevia with proposed risk factors was analysed statistically.

Results: Present study showed that the risk of developing placenta praevia in future pregnancy increased steadily as the number of previous caesarean sections increased, risk being 2.1, 2.8 and 4 times with previous one, two and three caesarean deliveries respectively. Similarly, the risk of developing placenta praevia was more in women with history of previous abortion (risk being 2.8 and 6.5 times more in women with one and two abortions in the past). Previous dilatation and curettage and age more than 30 years also proved to be independent risk factors.

Conclusions: To conclude advanced maternal age, previous abortion, dilatation and curettage and a history of previous caesarean section appear to increase the occurrence of placenta praevia. The study strongly emphasises the need to decrease the primary caesarean section rate.

References

Filippi V, Chou D, Ronsmans C. Levels and causes of maternal mortality and morbidity. In: Black RE, Laxminarayan R, Temmerman M, editors. Reproductive, maternal, new born and child health: disease control priorities, Washington DC; 2016.

Gupta B, Mishra, R. Antepartum Haemorrhage. In: Mishra R, eds. Ian Donald’s practical obstetric problems. 7th ed. Wolters Kluwer; 2014:315-338.

Cresswell JA, Ronsmans C, Calvert C, Filippi V. 2013. Prevalence of placenta praevia by world region: a systematic review and meta-analysis. Top Med Inter Heal. 2013;18:712-24.

Portal P. The complete practice of men and women midwives: or the true manner of assisting a woman in child-bearing. Paris 1685 English translation, London: J Johnson; 1763:143-4.

Obstetrical Hemorrhage. In: Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman B L et al. eds. Williams obstetrics. 24th ed. McGraw-Hill; 2014:780-828.

Saeed Z, Saeed M, Ikram M, Saeed R, Tazian S.. Placenta praevia; etiology and fetomaternal outcome. Professional Med J. 2009;16(1)139-44.

Lavery SP. placenta praevia. Clinical Obstet Gynaecol. 1990;33:414.

Dashe JS, McIntire DD, Ramus RM, Santos-Ramos R, Twickler DM. Persistence of placenta previa according to gestational age at ultrasound detection. Obstetrics Gynecol. 2002;99(5):692-7.

Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. 2016. The increasing trend in caesarean section rates: global, regional and national estimates: 1990-2014. PloS one. 2016 Feb 5;11(2):e0148343.

Trends in maternal mortality: 1990 to 2015, executive summary, estimates by WHO, UNICEF, UNFPA, World Bank Group and the united nations population division. Available at: https://apps.who.int/iris/bitstream/handle/10665/193994/WHO_RHR_15.23_eng.pdf;jsessionid=1BF679E3A062D7FB661227A923C3EC17?sequence=1. Accessed on 3 April 2019.

Menacker F, Hamilton BE. Recent trends in caesarean delivery in united states. NCHS data Brief. 2010;(35):1-8.

Potter JE, Berquó E, Perpétuo IH, Leal OF, Hopkins K, Souza MR, et al. Unwanted caesarean sections among public and private patients in Brazil: prospective study. Br Med J. 2001;323:1155-58.

Rose AA, Gopalan U. Correlation of maternal age with placenta praevia. Inter J Medical Res Review. 2015;3(9).

Malik AM, Shah IA, Siddique S. Placenta previa; a study to determine responsible factors. Professional Medical Journal-Quarterly. 2007;14(3):407-10.

Koo YJ, Ryu HM, Yang JH, Lim JH, Lee JE, Kim MY, et al. Pregnancy outcomes according to increasing maternal age. Taiwanese J Obst Gynecol. 2012;51(1):60-5.

Zhang J, Savitz DA. Maternal age and placenta previa: a population-based, case-control study. American J Obstetrics Gynecol. 1993;168:641-5.

Bhat SM, Hamdi IM, Bhat SK. Placenta previa in a referral hospital in Oman. Saudi Med J. 2004;25(6):728-31.

Nasreen F. Incidence, causes and outcome of placenta previa. J Postgraduate Medical Institute (Peshawar-Pakistan). 2011 Sep 23;17(1):99-104.

Cieminski A, Długołecki F. Relationship between placenta previa and maternal age, parity and prior caesarean deliveries. Ginekologia Polska. 2005;76(4):284-9.

Kiondo P, Wandabwa J, Doyle P. Risk factors for placenta praevia presenting with severe vaginal bleeding in Mulago hospital, Kampala, Uganda. African Heal Sci. 2008;8(1):44-9.

Karami M, Jenabi E. Placenta praevia after prior abortion: a meta-analysis. Biomed Res Therapy. 2017;4(7):1411-50.

Swetha B. Study on association of placenta praevia with previous caesarean section pregnancy. J Dental Med Sci. 2016;15(5):60-3.

Gilliam ML, Stolti K, Rosenberg D, Handler A, Davis F. Increased risk of placenta previa associated with prior cesarean delivery. Obst Gynecol. 2001;97(4):S6.

Sheiner E, Shoham-Vardi I, Hallak M, Hershkowitz R, Katz M, Mazor M. Placenta previa: obstetric risk factors and pregnancy outcome. J Maternal-Fetal Med. 2001;10(6):414-9.

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Published

2019-05-29

How to Cite

Kaul, S., & Mir, S. (2019). A study on correlation of placenta praevia with previous caesarean section and other risk factors. International Journal of Research in Medical Sciences, 7(6), 2027–2033. https://doi.org/10.18203/2320-6012.ijrms20192477

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Original Research Articles