PLACENTA PREVIA ACCRETA AND PRIOR CESAREAN-SECTION

  • 1 January 1985
    • journal article
    • research article
    • Vol. 66  (1) , 89-92
Abstract
To assess the relationship between increasing numbers of previous cesarean sections and the subsequent development of placenta previa and placenta accreta, the records of all patients presenting to labor and delivery with the diagnosis of placenta previa were examined. Of a total of 97,799 patients, 292 (0.3%) had a placenta previa. The risk of placenta previa was 0.26% with an unscarred uterus and increased almost linearly with the number of prior cesarean sections to 10% in patients with 4 or more. The effect of advancing age and parity on the incidence of placenta previa was much less dramatic. Patients presenting with a placenta previa and an unscarred uterus had a 5% risk of clinical placenta accreta. With a placenta previa and 1 previous cesarean section, the risk of placenta accreta was 24%; this risk continued to increase to 67% (2 of 3) with a placenta previa and 4 or more cesarean sections. Possible mechanisms and clinical implications are discussed.

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