Maternal Outcome with placenta praevia post uterine Surgery

Original article


Basma El-Mokadmi1, Asma Arebi1, Abdulla Eljaly2, Abdelgani Elbadri2

1-Obstetrics and Gynaecology Department, Tripoli Medical Centre.
2- Obstetrics and Gynaecology Department, Faculty of Medicine, Elfateh University, Tripoli, Libya

JMJ Vol.6 No.1 (Autumn) 2006: 45-49


Placenta praevia is associated with a recognizable maternal morbidity especially in patients with history of uterine surgery. The most important of these complications is the presence of a morbidly adherent placenta, as it leads to post-partum haemorrhage, and it’s complications. The objective of this study is to compare the outcome of patients of placenta praevia with history of uterine surgery to those who had no history of uterine surgery (in the form of caesarean section, evacuation and curettage or dilation and curettage). The study is a retrospective descriptive study in which 83 patients with placenta praevia were admitted to the obstetric department at Tripoli Medical Centre, and they were delivered by caesarean section in the period from the 1st of November 2000 to the end of January 2004. The study group was divided into 3 groups. One with previous history of caesarean delivery, the second group with history of miscarriage followed by dilatation or evacuation and curettage, and the third group with no history of uterine surgery. The intrapartum and postpartum complications were compared. The results showed that 19 patients 23% had history of previous caesarean sections, out of them 26.3% had adherent placenta, 73.7% had intra-operative bleeding, 21% had caesarean hysterectomy, and 73.7% had blood transfusion, while 23 patients 28% had history of uterine curettage, 4.3% of them had adherent placenta, 65.2% had intra-operative bleeding, 13% had caesarean hysterectomy, and 69.6% had blood transfusion, compared to 41 patients who had no history of uterine surgery, out of which 4.9% had adherent placenta, 56% had intra-operative bleeding, 9.8% had caesarean hysterectomy, and 61% had blood transfusion. Conclusion: Previous uterine surgery is associated with increased maternal morbidity in patient with Placenta praevia.

Keywords: Placenta praevia, Scarred uterus, History of curettage, Adherent placenta