Lady Reading Hospital, Peshawar

Objectives: To find the association of placenta praevia and morbid adherence of placenta in scarred uteri. Material and Methods: This descriptive study was conducted at Department of Obstetrics and Gynaecology, Lady Reading Hospital, Peshawar from January 2001 to Novermber 2005. All patients with a previous history of lower segment caesarian section presenting with placenta praevia after 36 weeks were included. Results: The number of deliveries during this period was 20100. Patients with placenta praevia numbered 566 (2.8%). Forty-five (4.5%) of the 990 patients with scarred uteri had placenta praevia. This figure was 2.8% in patients with no history of caesarian section. The frequency of placenta praevia in patients with a history of one caesarian section was 3.36% against 27.77% in those with four. There were 7 (17.7%) patient with placenta accreta and 1 patient with placenta increta in women with scarred uteri and 2 (0.38%) patient with placenta accreta with placenta praevia in unscarred uteri. The risk of abnormal placental adherence increased in direct proportion to the number of scars, being 16.66% in one scar and 33.33% in three or more scars. Conclusion: Previous caesarian section increases the risk of placena praevia and morbid adherence of placenta.The greater the number of scars in the uterus, the greater the risk.

Article: Original Article

Keywords:

Placenta Previa.
Obstetrics.
Reading.
Gynecology.
Placenta.
Uterine Diseases.
Morbidity.
Cesarean Section.
Hospitals.

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