Document Type : Original Article
Obstetrics and Gynecology, faculty of medicine,Tanta University, Tanta, Egypt
Obstetrics and gynecology faculty of medicine Tanta university Tanta Egypt
Obstetrics and gynecology faculty of medicine Zagazig university Egypt
Objective: To assess the association between the characteristics of patients with previous cesarean delivery and placenta accreta spectrum (PAS).
Patients and Methods: This multicenter case-control study was conducted at Obstetrics and Gynecology Departments of Tanta and Zagazig Universities in the period from January, 1, 2017 to December, 31, 2021. One hundred twenty cases of placenta accreta were compared to 120 matched cases without placenta accretes at the time of delivery. Characteristics of previous cesarean delivery were recorded in PAS and control cases.
Results: Demographic data were matched in PAS and control cases. Presence of placenta accrete spectrum was associated with many risk factors in previous cesarean surgery. There was a significant difference between both groups regarding history of dilatation and curettage (OR=3.996, CI=2.276-7.017), operator experience, manual removal of the placenta (OR=4.923, CI=2.743-8.837), postpartum fever (OR=3.561, CI=2.038-6.224), IUD use before pregnancy (OR=6.889, CI=3.887-12.211), place of delivery and layers of suture of uterine incision (OR=3.609, CI=2.115-6.158).
Conclusion: Patients' characteristics at previous cesarean section and the postpartum events are very important determining factor for placental adhesive disorders; history of D&C, operator experience, manual removal of the placenta, postpartum fever and IUD use before pregnancy , place of delivery and layers of suture of uterine incision. The data and the finding of all cesarean deliveries should be accurately recorded to evaluate the future risk of PAS.