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- Title
PLACENTAL LOCATION AFTER CESAREAN SECTION.
- Authors
Aleksandra, Vejnović; Jelena, Zorić; Dunja, Puškar; Divna, Subotin; Jarmila, Šproh Beljička; Dragan, Đorđević
- Abstract
Objectives: Most serious complications after cesarean occur at the site of the uterine scar, including placental complication i.e. placenta accreta, which can cause massive post partum hemorrage. There is a close correlation between the number of previous cesarean sections and risk for such complication. Thus, location of the placenta in following pregnancies is important data for providing safer health care, and is contained routinely in third trimester ultrasound report.The aim of this study was to determine if cesarean section causes more frequent implantation of the placenta to the anterior wall of the uterus. Secondary aim was to investigate if placental location influences fetal and placental growth. Methods: Medical records of 847women delivered by cesarean section were reviewed retrospectively. Placental location was identified from routine preoperative ultrasonography reports. Placental location was categorised as anterior, posterior, fundal or lateral. The frequencyofcertain placental location was calculated depending on the number of previous caesarean sections and interval between to cesarean section in woman. Birth weight of newborn and placenta as well as weight of mother were correlated and compared depending on placental location. All data were statistically analysed. Results: The mean age of the patients was 31.6± 5.2 years. First cesarean section was performed in 50.1% (424/847) patients, second in 41.9% (355/847), third in 7.2% (61/847) and fourth in 0.8% (7/847). Anterior location of the placenta was found in 46.7% of patients to whom first cesarean was performed, 49.3% patients with one previous cesarean section, 44.3% with two previous cesarean section and 71.4% with three previous cesarean sections. There was significant difference in distribution of placental location depending on number of cesarean section (p=0.0241). There was positive correlation between birth weight of the fetus and placenta (r=0.663, p<0.001), and weight of mother and weight of placenta (r=0.243, p<0.001). Significant difference in birth weight of newborn was noticed depending on placental location (p=0.042). Placenta was more frequently implanted on anterior wall when interval between two cesarean sections was less than 3 years (p<0.05, figure 1). Conclusions: The frequency of anterior location of placenta is increasing with rising number of previous cesarean sections. The interval between the cesarean section influences the location of placenta. Placental location influences the weight of newborn which may represent better vascularisation of different segments of uterine wall and may also influence amount of blood loss during operation.
- Subjects
SERBIA; CESAREAN section; CONFERENCES &; conventions; PLACENTA; POSTOPERATIVE period
- Publication
Journal of Perinatal Medicine, 2017, Vol 45, p42
- ISSN
0300-5577
- Publication type
Article
- DOI
10.1515/jpm-2017-3001