FREQUENCY OF PLACENTA PREVIA AND ITS COMPLICATIONS IN PATIENTS WITH REPEATED CESAREAN SECTION

Abstract

Objective: To determine the frequency of placenta previa and it’s associated maternal and fetal complications among patients with a history of repeated cesarean section.

Study Design: Cross-sectional descriptive study.

Place and Duration of Study: Department of Obstetrics and Gynecology, department of Obstetrics and Gynecology, Lady Willingdon Hospital, Khairpur (Mir’s), Sindh, from 25^th February 2025 to 25^th May 2025.

Materials and Methods: A total of 210 pregnant women with at least one previous cesarean section, gestational age beyond 28 weeks, were enrolled through non-probability consecutive sampling. Placenta previa was diagnosed on ultrasonography and confirmed intra-operatively. Data on age, parity, body mass index (BMI), number of previous cesarean sections, and maternal and fetal complications were recorded on a structured proforma and analyzed using SPSS version 25.0. The Chi-square test was applied after stratification, with p ≤ 0.05 taken as significant.

Results: Placenta previa was found in 40 of 210 patients (19.0%). Its frequency was significantly higher in women with two or more previous cesarean sections (32.9%) compared with those with fewer than two (12.1%) (p = 0.001). The frequency also rose significantly with increasing parity, from 14.4% in women with parity <3 to 25.0% in those with parity ≥3 (p = 0.047), and with increasing BMI, from 10.5% in normal-weight women to 40.7% in obese women (p = 0.002). No significant association was found with maternal age (p = 0.098). Among the previa cases, postpartum hemorrhage occurred in 60.0%, blood transfusion was required in 65.0%, placenta accreta spectrum was confirmed in 27.5%, and cesarean hysterectomy was performed in 17.5%.

Conclusion: Placenta previa is significantly associated with an increasing number of previous cesarean sections, higher parity, and higher BMI, and it carries a considerable burden of maternal and neonatal morbidity. Targeted antenatal surveillance is warranted in women with these risk factors.