• Saudi Med J · Oct 2024

    Impact of high-order repeat cesarean deliveries on early maternal complications among major placenta previa patients in Southern Saudi Arabia.

    • Ayman H Shaamash, Mehad H AlQasem, Ahmed A Mahfouz, Deama S Al Ghamdi, Norah I Almanie, and Mamdoh A Eskandar.
    • From the Department of Obstetrics and Gynecology (Shaamash, AlQasem, Al Ghamdi, Almanie, Eskandar); from the Department of Family and Community Medicine (Mahfouz), College of Medicine, King Khalid University, and from the Department of Obstetrics and Gynecology (Shaamash, AlQasem, Al Ghamdi, Almanie, Eskandar), Abha Maternity and Children's Hospital, Abha, Kingdom of Saudi Arabia.
    • Saudi Med J. 2024 Oct 1; 45 (10): 104910561049-1056.

    ObjectivesTo investigate the rates and odds ratios (ORs) of early maternal complications among patients with major placenta previa (PP) who have undergone high-order repeat cesarean deliveries (HOR-CDs) in comparison to those with low-order repeat cesarean deliveries (LOR-CDs).MethodsWe carried out a retrospective review of all major PP patients (n=184) who delivered through second or subsequent repeat CDs, from January 2012 to December 2021 (Abha Maternity and Children's Hospital, Abha, Saudi Arabia). The patients were categorized into 2 groups: the LOR-CDs group (n=100), comprising individuals with their second and third CDs (CD2-CD3) and the HOR-CDs group (n=84), consisting of those undergoing their fourth to seventh CDs (CD4-CD7).ResultsIn comparison to the LOR-CDs, the HOR-CDs group with major PP exhibited significantly higher rates and ORs of early maternal complications, including MRI-diagnosed placenta accreta spectrum (PAS, OR=2.67), transfusions of packed red blood cells (OR=2.71), moderate to severe intra-operative bleeding (OR=1.80), emergency hysterectomy (OR=2.96), urological injuries (OR=3.17), and length of post-operative hospital stay (OR=3.91). The major PP subgroup undergoing CD6-CD7 showed the highest rates and ORs for PAS diagnosis at 84.6% (OR=3.98) and emergency hysterectomy at 28.6% (OR=4.04).ConclusionAmong patients with major PP, undergoing more than 3 CDs is associated with a notable increase in both the rates and ORs of various early maternal complications. This trend of increasing many complications correlates directly with an ascending number of CDs.Copyright: © Saudi Medical Journal.

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