Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Womens' Health and Teaching Hospital, Health Science University, Ankara, Turkey.
Medical Faculty, Department of Obstetrics and Gynecology, Bozok University, Yozgat, Turkey.
J Matern Fetal Neonatal Med. 2020 Oct;33(19):3238-3243. doi: 10.1080/14767058.2019.1570121. Epub 2019 Jan 22.
To appraise the impact of previous birth type and the number of deliveries on placenta previa incidence and the extent of intrapartum massive hemorrhage. Placenta previa complications among healthy singleton subsequent pregnancies following previous pregnancies without placenta previa history were classified according to their birth types and previous numbers of parity. Subgroups of subsequent pregnancies with massive hemorrhage and placental adhesion anomalies were compared. One, two, three or more previous cesarean births triggered a significant increase in the rate of massive hemorrhage when compared to subgroups of previous vaginal births (31.5% versus 50.9%, = .02; 32.7% versus 69.0%, = .001; and 42.9% versus 81.9%, = .035, respectively). The rate of placental adhesion anomalies in all subgroups of previous cesarean births were statistically higher than subgroups of previous vaginal births (12.4 versus 32.7%, = .003; 10.2% versus 52.2%, = .001; and 9.5% versus 63.6%, = .001, respectively). Urogenital complications in women with one previous cesarean birth were higher than those of the vaginal birth group (9.1 versus 0%, = .004). Previous cesarean births are more frequently associated with increased massive hemorrhage and placental adhesion anomalies in subsequent pregnancies with placenta previa when compared to previous vaginal births.
评估既往分娩类型和分娩次数对前置胎盘发生率和产时大出血程度的影响。将既往无前置胎盘史的健康单胎后续妊娠根据分娩类型和既往产次分为不同组别。比较大出血和胎盘粘连异常的亚组。与既往阴道分娩亚组相比，既往剖宫产分娩次数为 1 次、2 次、3 次或更多次，会显著增加大出血的发生率（31.5%比 50.9%， = .02；32.7%比 69.0%， = .001；42.9%比 81.9%， = .035）。既往所有剖宫产分娩亚组的胎盘粘连异常发生率均明显高于既往阴道分娩亚组（12.4%比 32.7%， = .003；10.2%比 52.2%， = .001；9.5%比 63.6%， = .001）。既往剖宫产分娩 1 次的女性比阴道分娩组更容易发生泌尿生殖系统并发症（9.1%比 0%， = .004）。与既往阴道分娩相比，既往剖宫产分娩与前置胎盘的后续妊娠中，大出血和胎盘粘连异常更为常见。
