The higher frequency of Cesarean deliveries may be attributable to anticipatory management by physicians seeking to avoid such complications as antepartum hemorrhage, as well as to the increased rate of placenta previa
seen among the EDS cohort, Dr.
Our data also will facilitate counseling of women with placenta previa
and prior cesarean deliveries regarding their risks of placenta accrete.
The duration of surgery and the amount of blood loss were significantly higher, which was possibly the result of the increased prevalence of placenta previa
, placenta accreta and peripartum hysterectomy.
Previous prelabor or intrapartum cesarean delivery and risk of placenta previa
. Am J Obstet Gynecol 2015;212:669.e1-6.
(14) Even in Finberg's original work, 27% of cases of confirmed PAS had Grade 0 or Grade 1 placental lacunae and 11% of cases of placenta previa
, without PAS, demonstrated Grade 2 lacunae.
Decreased maternal mortality in EPH cases is most likely due to the increased success of prenatal diagnosis of placenta previa
It has been presented that women who had a history of placenta previa
with a previous uterine scar had a 16% higher risk of hysterectomy compared with 3.6% in women with unscarred uteri (5,14,21).
examined histological samples from 23 patients with PAS compared to a control group of 25 patients with a normal pregnancy and 21 with nonadherent placenta previa
describe several cases where internal iliac ligation is helpful and safe in the surgical management of patients with placenta previa
and/or percreta to reduce blood loss and risk of reoperation .
Our patient had undergone caesarean delivery for placenta previa
. Multiple hemostatic sutures during cesarean section for placenta previa
have been demonstrated to be an important causative factor in hematometra formation.
Battledore insertion of cord was also found to have increased association with placenta previa
, abruptio placentae, preeclampsia, preterm delivery, cord prolapse, foetal distress, increased incidence of emergency LSCS, low Apgar score, NICU admission, low birth weight and congenital malformations (8, 9).
Regarding systemic complications grand multiparas are at high risk of developing hypertension, diabetes, anemia and obesity.7 While regarding obstetric complications these women are at increased risk of malpresentations, obstructed labour, placenta previa
, placenta abruption, retained placenta, ruptured uterus, post partum hemorrhage, caesarian sections and caesarian hysterectomy.