Department of Obstetrics and Gynecology, Patan Academy of Health Sciences, Kathmandu, Nepal.
J Nepal Health Res Counc. 2022 Jun 2;20(1):142-146. doi: 10.33314/jnhrc.v20i01.3640.
Placenta previa is associated with poor maternal and fetal outcomes. Its complications are increasing due to the increased rate of cesarean deliveries. This study aimed to compare maternal and fetal outcomes in placenta previa with and without previous cesarean section.
This study was conducted in the Department of Obstetrics and Gynecology at Patan Hospital, Nepal. Placenta previa cases were reviewed from 1st January 2010 to 31st December 2019, parted into Group 1 (placenta previa with previous cesarean section) and Group 2 (placenta previa with no prior cesarean section). Strength of association was measured as odds ratio and 95% confidence intervals. P-value at <0.05 was taken as statistically significant.
The total number of placenta previa were 348 (0.42%) of total deliveries (n=82,918) , but 72 charts/records were not found and six cases were excluded. Group 1 comprised 48 cases (0.86%) among prior cesarean section (n=5,581) and Group 2 consisted of 222 cases (0.28%) among those with no prior cesarean delivery (n=77,337) and it was statistically significant. Morbidly adherent placenta, postpartum hemorrhage, cesarean hysterectomy, and maternal deaths were higher in Group 1 and statistically significant. Preterm deliveries and neonatal intensive care unit admission were also more in Group 1 and statistically significant.
Maternal and fetal morbidity were higher in placenta previa with previous cesarean section than with no prior cesarean delivery. Therefore, it is advisable to try to reduce the rate of cesarean section as far as possible.
前置胎盘与不良母婴结局相关。由于剖宫产率的增加，其并发症也在增加。本研究旨在比较有既往剖宫产史和无既往剖宫产史的前置胎盘患者的母婴结局。
本研究在尼泊尔巴坦医院妇产科进行。回顾 2010 年 1 月 1 日至 2019 年 12 月 31 日期间的前置胎盘病例，分为第 1 组（有既往剖宫产史的前置胎盘）和第 2 组（无既往剖宫产史的前置胎盘）。关联强度以比值比和 95%置信区间表示。P 值<0.05 被认为具有统计学意义。
前置胎盘总例数为 348 例（0.42%），占总分娩例数（n=82918）的比例，但有 72 份图表/记录未找到，6 例被排除。第 1 组包括 5581 例剖宫产中 48 例（0.86%），第 2 组包括 77337 例无剖宫产史中 222 例（0.28%），差异具有统计学意义。第 1 组的粘连性胎盘、产后出血、剖宫产子宫切除术和产妇死亡的发生率较高，且具有统计学意义。第 1 组早产儿分娩和新生儿重症监护病房入住的比例也较高，且具有统计学意义。
有既往剖宫产史的前置胎盘患者的母婴发病率高于无既往剖宫产史者。因此，应尽量降低剖宫产率。
