Ashraf Saima, Qadir Saima Yasmeen, Khosa Arooj Fatima
Saima Ashraf, FCPS (Obstetrics & Gynecology), Department of Obstetrics & Gynecology, Nishtar Medical University, Multan, Pakistan.
Saima Yasmeen Qadir, FCPS (Obstetrics & Gynecology), Department of Obstetrics & Gynecology, Nishtar Medical University, Multan, Pakistan.
Pak J Med Sci. 2023 Jan-Feb;39(1):60-63. doi: 10.12669/pjms.39.1.6656.
To analyze the impact of previous cesarean section on rates of obstetrical hysterectomy among women with placenta previa.
A retrospective cohort study done at the Department of Obstetrics & Gynecology, Nishtar University Hospital, Multan from January 2017 to December 2021. A total of 374 women aged between 20 to 50 years with diagnosis of placenta previa who underwent cesarean delivery were included. Age, BMI, area of residence, gestational age, gravidity status and past history of cesarean section were noted from medical records of all women. Relationship of previous number of cesarean sections and with obstetrical hysterectomy was noted among women with placenta previa.
In a total of 374 women, mean age was 33.45±7.3 years. Mean gestational age was 37.4±3 weeks. Obstetrical hysterectomy was done in 110 (29.4%) women. Significant association of gravidity status was noted with hysterectomy as 95 (86.4%) women with hysterectomy had gravidity status ≥3 in comparison to 197 (74.6%) with no hysterectomy (p=0.030). Number of cesarean section was found to have significant association with obstetrical hysterectomy as 55 (50.0%) women with obstetrical hysterectomy reported ≥3 previous cesarean section versus 29 (11.0%) with no obstetrical hysterectomy (p<0.001).
Strong association of previous number of cesarean section and obstetrical hysterectomy was found with placenta previa. There should be protocols for early identification and prediction of adverse outcomes among women with placenta previa with past history of cesarean section.
分析既往剖宫产对前置胎盘女性产科子宫切除术发生率的影响。
在木尔坦尼什塔尔大学医院妇产科进行的一项回顾性队列研究，时间为2017年1月至2021年12月。纳入了374例年龄在20至50岁之间、诊断为前置胎盘并接受剖宫产的女性。从所有女性的病历中记录年龄、体重指数、居住地区、孕周、孕次情况及既往剖宫产史。记录前置胎盘女性既往剖宫产次数与产科子宫切除术之间的关系。
374例女性的平均年龄为33.45±7.3岁。平均孕周为37.4±3周。110例（29.4%）女性接受了产科子宫切除术。孕次情况与子宫切除术存在显著关联，接受子宫切除术的95例（86.4%）女性孕次≥3，而未接受子宫切除术的197例（74.6%）女性孕次≥3（p = 0.030）。剖宫产次数与产科子宫切除术存在显著关联，接受产科子宫切除术的55例（50.0%）女性报告既往剖宫产≥3次，而未接受产科子宫切除术的29例（11.0%）女性报告既往剖宫产≥3次（p<0.001）。
发现既往剖宫产次数与前置胎盘女性的产科子宫切除术之间存在密切关联。对于有剖宫产史的前置胎盘女性，应制定早期识别和预测不良结局的方案。
