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Am J Obstet Gynecol. 2005 Sep;193(3 Pt 2):1045-9.

Placenta previa-accreta: risk factors and complications.

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1
Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.

Abstract

OBJECTIVE:

The purpose of this study was to identify risk factors and complications of placenta previa-accreta (PA).

STUDY DESIGN:

Patients with placenta previa (n = 347) delivered over 20 years were reviewed, divided into PA (cases, n = 22) and no accreta (controls, n = 325), and compared.

RESULTS:

Cases were older with a higher incidence of smoking and previous cesarean delivery (CS). Grandmultiparity, recurrent abortions, anterior/central placentae, and low socioeconomic status were similar. PA incidence increased with the number of previous CS: 1.9%, 15.6%, 23.5%, 29.4%, 33.3%, and 50.0% after 0, 1, 2, 3, 4, and 5 previous CS, respectively. Hypertensive disorders (odds ratio [OR] 13.9, 95%CI 2.1-91.2], P = .006), smoking (OR 3.4, 95%CI 1.1-10.2, P = .031) and previous CS (OR 7.9, 95%CI 1.7-37.4, P = .009) were selected by the stepwise logistic regression analysis as predictors of PA. Cases had a longer hospital stay, a higher estimated blood loss, and need for transfusion. Cesarean hysterectomy and hypogastric artery ligation were only performed in PA cases. The 2 groups had a similar delivery gestational age and neonatal outcome.

CONCLUSION:

Hypertensive disorders, smoking, and previous cesarean are risk factors for accreta in placenta previa patients. Placenta previa-accreta is associated with higher maternal morbidity, but similar neonatal outcome compared with patients with an isolated placenta previa.

PMID:
16157109
DOI:
10.1016/j.ajog.2005.06.037
[Indexed for MEDLINE]
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