Comparative Study of Obstetrics Outcome Between Scarred and Unscarred Uterus in Placenta Previa Cases

Abstract

Objective(s): To compare the incidence of placenta previa, associated factors, complications, placental position, mode of delivery
and fetal and maternal outcome in scarred (Group A) and unscarred uterus (Group B) in 20 months of hospital-based study.
Material and methods: In a prospective study, 140 cases of pregnancies beyond 28 weeks of gestation complicated by placenta
previa were identified. These cases were divided into two groups, scarred uterus (Group A, n = 34) and unscarred uterus
(Group B, n = 106). Total number of deliveries were 16,784 out of which 2,354 patients had cesarean section and 140 patients had
placenta previa. Results: The incidence of placenta previa in scarred cases is significantly higher (1.2%) than overall incidence
(0.6%). Majority of scarred cases had anterior placenta (85.2%) and majority of unscarred cases had posterior placenta (63.2%)
(p = 0.00, HS). The number of unbooked cases in both Groups A and B was high (p = 0.404, NS). A significant association of
placenta previa following curretage in Group B was observed (p = 0.002, S). There was only one maternal mortality in Group B
and none in Group A. Results showed a favorable fetal outcome in both groups. (Group A-70.6%, Group B-64.2%, p = 0.08, NS).
Conclusion(s): An increase in the incidence of prior cesarean section and advanced maternal age probably contribute to a rise in
the number of pregnancies complicated with placenta previa and its association with adverse maternal and perinatal outcome.