Frequency of Placenta Previa and Maternal Morbidity Associated with Previous Cesarean Delivery

Background: Placenta previa (P.P) is a rare pregnancy complication where a placenta particularly or completely covers the internal cervical os thereby preventing normal vaginal delivery. This study was conducted to evaluate the relationship between repeated cesarean deliveries and subsequent development of placenta previa. Methods & Materials: This cross-sectional study was held in Imam Reza Hospital Kermanshah-Iran during 2008-2011. This study included all pregnant women with repeated cesarean sections while nullipara and patients with placenta previa without previous surgery were excluded. Diagnosis was made on ultrasound and at surgery. Results: among 2696 Women, 98 cases had P.P (3.63%). The mean age was 30 years, 76.5% (75 cases) had gravidity 2 and 3 and 87.8% (86 cases) had parity 1 - 3. Anterior location of placenta was 44.9% while posterior was 55.1%. 48% were complete P.P, 32.7% low lying P.P, 13.3% marginal P.P, and 6% Partial P.P. 26.5% of patients had history of abortion. 55.1% of patients had male fetus. There was an increase in frequency of placenta previa with just one previous C-section (74.5%). Frequency of accreta P.P 32% (n = 7), increta (14.3%, n = 3) and percreta 28% (n = 6). Among those who underwent emergency hysterectomy (21 cases) 23.8% cases had no abnormal placentation. 30.6% of newborns had birth weight < 2500 g. Conclusion: we concluded that patients with history of one pervious cesarean delivery had more Placenta previa and need to hysterectomy were more than those with history of 2 and 3 previous cesarean delivery. The most common type of abnormal placentation was accreta, percreta and increta respectively.