Risk of Association of Placenta Praevia with History of Uterine Scar

Background: In Placenta Previa the placenta is implanted in the lower uterine segment in pregnancy with previous Caesarian Section there is risk of placenta being adherent with the scar, leading to devastating hemorrhage. The aim of this study was to find out the risk of association of placenta praevia with history of uterine scar. Methods: It was a hospital based observational cross-sectional study and was carried out in Department of Obstetrics and Gynecology. Dhaka Medical College and Hospital, Dhaka from May 2013 to October 2013. Total 50 patients were enrolled as diagnosed case of placental praevia. Patients clinical condition and course of management, perinatal outcome were observed, recorded & categorized Data were analyzed using computer with Statistical Package for Social Sciences (SPSS) software for Windows version 20. Results: This study shows commonest age group was 26-30 years, which included 46%, 36% belonged to 31-35 years age group. The average age was 29.80 years. Most (94%) of the patients were multigravida Maximum (54%) number of cases were admitted during the gestational period of 35-38 weeks. Common clinical presentations were anaemia (80%) and per vaginal bleeding (84%). Regarding management, 76% patients were managed actively and 24% patients were managed expectantly. It was observed that placenta praevia with uterine scar is seen more frequently (66%) in cases of previous caesarean sections. Among 30 patients, 84% were live births, 10% were still births and 6% were neonatal deaths. No maternal death was observed in this study. Conclusion: This study shows strong association between previous caesarean section, uterine curettage and hysterotomy and placenta praevia. Most of the patients were provided with active modality of management. Hence the study advocates the use of contraceptive, advanced antenatal care & early referral to hospital and expectant management of patients after proper selection to reduce the premature birth.