Clinical Outcomes of Placenta Previa in Women with a Previous Cesarean Section: A Comparison by Placenta Accreta Spectrum Status
Abstract: Background: Placenta previa in women with previous cesarean delivery is associated with placenta accreta spectrum (PAS), obstetric haemorrhage, operative morbidity and adverse perinatal outcomes. Methods: This retrospective observational study included 81 women with placenta previa and previous cesarean delivery. Patient-level data from the study master chart were analysed for demographic characteristics, obstetric history, PAS, timing and mode of delivery, maternal morbidity and neonatal outcomes. PAS was defined as a recorded diagnosis of accreta, increta or percreta. Categorical variables were compared using Fisher's exact test or the chi-square test, as appropriate. Odds ratios (ORs) were calculated for selected binary outcomes. Results: PAS was recorded in 39 women (48.1%), including accreta in 20 (24.7%), increta in 12 (14.8%) and percreta in 7 (8.6%). Postpartum haemorrhage occurred in 32 women (39.5%), and 75 (92.6%) received blood or blood products. Urinary tract injury occurred in 4 (4.9%), DIC in 3 (3.7%), puerperal sepsis in 7 (8.6%), obstetric hysterectomy in 10 (12.3%) and ICU admission in 27 (33.3%). Two maternal deaths were recorded (2.5%). Twenty-eight births (34.6%) were preterm, 29 neonates (35.8%) had low birth weight, 20 (24.7%) required NICU admission and 10 stillbirths (12.3%) were recorded. Obstetric hysterectomy was more frequent in women with PAS than in those without recorded PAS (20.5% vs 4.8%; OR 5.16, 95% CI 1.02-26.05; p=0.043). No statistically significant association was observed between PAS and the other maternal outcomes analysed. Conclusion: In this cohort of women with placenta previa and previous cesarean delivery, maternal morbidity and transfusion requirements were substantial. PAS was associated with a higher frequency of obstetric hysterectomy. Antenatal identification of women at risk and delivery in a facility prepared for major obstetric haemorrhage and complex pelvic surgery are important in this population.
Keywords: placenta previa; previous cesarean delivery; placenta accreta spectrum; postpartum haemorrhage; obstetric hysterectomy; maternal morbidity; neonatal outcome
How to Cite?: Dr. Karuna Ramchandra Wayal, Dr. Sanjaykumar Tambe, "Clinical Outcomes of Placenta Previa in Women with a Previous Cesarean Section: A Comparison by Placenta Accreta Spectrum Status", Volume 15 Issue 10, October 2026, International Journal of Science and Research (IJSR), Pages: 1144-1146, https://www.ijsr.net/getabstract.php?paperid=SR261012222740, DOI: https://dx.doi.org/10.21275/SR261012222740